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目的:应用超声技术评价高血压患者左室舒张功能,并探讨其与胰岛素样类生长因子1的关系。方法:选择2003-06/2003-12齐鲁医院门诊及住院的单纯原发性高血压患者61例为高血压组。根据左室质量指数将患者分为左室心肌肥厚组30例和无心肌肥厚组31例。选择同期齐鲁医院门诊体检健康自愿者20例为对照组,男8例,女12例。脉冲波多普勒超声测量所有研究对象二尖瓣血流,根据二尖瓣瓣尖频谱测量舒张早期最大血流速度、晚期最大血流速度及其比值。多普勒组织成像测量二尖瓣环心肌舒张早期峰值运动速度、晚期峰值运动速度及其比值。所有研究对象均用放射免疫分析测定血清胰岛素样类生长因子1的浓度。结果:高血压患者二尖瓣瓣尖舒张早期、晚期最大血流速度比值明显小于对照组(P<0.01),左室心肌肥厚组二尖瓣瓣尖舒张早期最大血流速度/二尖瓣瓣尖晚期最大血流速度比值明显小于无心肌肥厚组(P<0.01);无心肌肥厚组、左室心肌肥厚组患者二尖瓣侧环心肌舒张早期峰值运动速度/心肌舒张晚期峰值运动速度比值(0.88±0.12,0.74±0.09)均小于对照组(1.42±0.11)(P<0.01);左室心肌肥厚组比值明显小于无心肌肥厚组(P<0.01)。无心肌肥厚组、左室心肌肥厚组患者血清胰岛素样生长因子1水平明显高于对照组(P均<0.001);左室心肌肥厚组血清?
OBJECTIVE: To evaluate left ventricular diastolic function in patients with essential hypertension by ultrasound and to explore its relationship with insulin-like growth factor-1 (IGF-1). Methods: Sixty-one patients with simple primary hypertension in outpatient department and hospitalized in Qilu Hospital from 2003-06 / 2003-12 were selected as hypertension group. According to the left ventricular mass index, the patients were divided into three groups: left ventricular hypertrophy group (n = 30) and non-cardiac hypertrophy group (n = 31). Select the same period Qilu Hospital outpatient health examination of 20 volunteers for the control group, 8 males and 12 females. Pulmonary doppler flow was measured by pulsed-wave Doppler sonography. The maximal diastolic velocity, the maximal late velocity, and its ratio were measured by mitral valve annulus. Doppler tissue imaging measured mitral annular early diastolic peak velocity, peak velocity and its ratio. All subjects were measured by radioimmunoassay serum insulin-like growth factor 1 concentration. Results: The ratio of early to late mitral apical diastolic velocity in hypertensive patients was significantly lower than that in the control group (P <0.01). In the left ventricular hypertrophy group, the maximal diastolic velocities in mitral valve tip early / mitral valve (P <0.01). The ratio of peak early diastolic velocity to late diastolic peak velocity in mitral annulus was significantly higher in patients without cardiac hypertrophy and in left ventricular hypertrophy than in those without cardiac hypertrophy (P <0.01) 0.88 ± 0.12,0.74 ± 0.09) were significantly lower than those in the control group (1.42 ± 0.11) (P <0.01); LVMI was significantly lower than those without cardiac hypertrophy (P <0.01). The levels of serum insulin-like growth factor 1 in patients without cardiac hypertrophy and left ventricular hypertrophy were significantly higher than those in the control group (all P <0.001)