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目的:探讨血清D-二聚体(D-D)与老年原发性高血压(EH)患者左室肥厚的相关性。方法:选取我院收治的老年EH患者158例为研究对象,均行心脏超声检查,依据左室质量指数(LVMI)将患者分为左室肥厚组(LVH组,n=72例)和非左室肥厚组(非LVH组,n=86例);分析比较两组患者血清D-D水平及相关实验室检查指标的差异。用Logistic回归模型分析血清D-D水平与左室肥厚的关系,用ROC曲线分析血清D-D水平预测老年EH患者发生左室肥厚的价值。结果:LVH组患者血清D-D水平[(315.54±45.70)μg/L]高于非LVH组[(148.29±37.65)μg/L](t=13.456,P<0.05);D-D增高组患者LVMI[(137.25±16.94)g/m~2]高于非LVH组[(104.39±14.84)g/m~2](t=12.876,P<0.05);D-D增高组中有发生左室肥厚的比例显著高于D-D正常组(65.1%vs 38.3%,X2=4.567,P<0.05)。血清D-D与LVMI呈正相关(r=0.354,P<0.05),与NT-pro BNP亦呈正相关(r=0.394,P<0.05)。血清D-D水平(OR=1.239,95%CI:1.134~1.548,P<0.05)是老年EH发生左室肥厚呈的独立相关因素。血清D-D预测发生左室肥厚的曲线下面积(ROCAUC)为0.879;灵敏度及特异度分别是89.8%及78.7%,最佳诊断截点为295.54μg/L。结论:老年EH患者血清D-D水平可能是左室肥厚发生的独立危险因素,血清D-D指标对于评价高EH患者左室肥厚的发生具有一定的临床意义。
Objective: To investigate the relationship between serum D-dimer (D-D) and left ventricular hypertrophy in elderly patients with essential hypertension (EH). Methods: A total of 158 elderly patients with EH admitted to our hospital were enrolled in this study. All patients underwent echocardiography. According to left ventricular mass index (LVMI), patients were divided into two groups: left ventricular hypertrophy group (LVH group, n = 72) Hypertrophy group (non-LVH group, n = 86 cases); analysis of the two groups of patients with serum DD levels and related laboratory test differences. Logistic regression model was used to analyze the relationship between serum D-D level and left ventricular hypertrophy. The ROC curve analysis of serum D-D level was used to predict the value of left ventricular hypertrophy in elderly patients with EH. Results: The level of serum DD in patients with LVH [(315.54 ± 45.70) μg / L] was significantly higher than that in patients without LVH [(148.29 ± 37.65) μg / L] 137.25 ± 16.94) g / m ~ 2] was significantly higher than that of non-LVH group [(104.39 ± 14.84) g / m 2] (t = 12.876, P <0.05) In DD normal group (65.1% vs 38.3%, X2 = 4.567, P <0.05). Serum D-D was positively correlated with LVMI (r = 0.354, P <0.05) and positively correlated with NT-pro BNP (r = 0.394, P <0.05). Serum D-D level (OR = 1.239, 95% CI: 1.134-1.548, P <0.05) was an independent factor related to left ventricular hypertrophy in elderly patients with EH. The predicted area under curve (ROCAUC) of serum D-D predicted left ventricular hypertrophy was 0.879; the sensitivity and specificity were 89.8% and 78.7%, respectively, and the best cutoff point was 295.54μg / L. Conclusion: Serum D-D level in elderly patients with EH may be an independent risk factor for left ventricular hypertrophy. Serum D-D index may be of clinical significance for the assessment of left ventricular hypertrophy in patients with high EH.