基于聚类分析的原发性高血压无创血流动力学特征的研究-东南大学学报医学版

基于聚类分析的原发性高血压无创血流动力学特征的研究

单位：1. 广州军区广州总医院干部病房五科, 广东广州 510010;
2. 广州中医药大学, 广东广州 510000

分类号：R544.1

出版年·卷·期（页码）：2018·37·第五期（808-813）

摘要：

目的：探讨不同年龄段高血压患者的无创血流动力学特征。方法：对191例高血压患者采用无创阻抗心动图方法检测血流动力学状态，运用聚类分析及因子分析的方法分析无创血流动力学数据，从而评价不同年龄段高血压患者的无创血流动力学特征及高血压分型。结果：年龄≤ 45岁的高血压患者的无创血流动力学特点是心排量大致正常，心率偏快，前负荷（胸液传导性）偏高，后负荷[每搏外周阻力（SSVR）、每搏外周阻力指数（SSVRI）]出现增高的趋势；年龄>45岁者的无创血流动力学特点为心输出量（CO）、心脏指数（CI）、心搏量（SV）、心搏指数（SI）降低，外周血管阻力[每搏外周阻力（SSVR）、系统阻力（SVR）]明显升高，心肌收缩力[射血收缩指数（EPCI）、变力状态指数（ISI）]降低。结论：青年原发性高血压患者的高血压分型多属于高动力型，发病多与工作学习压力大、容易焦虑、精神紧张、运动量少及饮食不规律相关。中老年高血压患者的高血压分型主要是高阻抗型，血管硬化，动脉顺应性和心脏指数的降低，导致系统血管阻力指数（SVRI）、动脉压及脉压的增高。

Objective:To investigate the noninvasive hemodynamics characteristics of hypertensive patients in different age groups. Methods:The hemodynamic status was measured by noninvasive impedance echocardiography in 191 hypertensive patients. Noninvasive hemodynamics datas were analyzed by using cluster analysis and factor analysis methods to evaluate the noninvasive hemodynamics characteristics and hypertension classification of hypertensive patients of different ages. Results:The noninvasive hemodynamic characteristics of hypertensive patients with age ≤ 45 years were characterized by rapid heart rate,normal cardiac output, high preload(thoracic fluid conductivity,TFC) and increasing postload. The postload was significantly increased and the myocardial contractility decreased in the noninvasive hemodynamic characteristics of the age>45 years. Conclusion:The classification of hypertension in young patients with essential hypertension is mostly a high-power type. The incidence of adolescent hypertension is related to anxiety, irregular diet, intense learning pressure, and very little exercise. Hypertension in elderly hypertensive patients is mainly high vascular resistance type, middle-aged hypertension in patients with vascular sclerosis, arterial compliance and decreased cardiac index, leading to increased systemic vascular resistance index (SVRI), arterial pressure and pulse pressure.

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