中文摘要：

目的通过比较超声心动图检测的左心房大小和左心室充盈压（LVFP）的关系，探讨左心房面积指数（LAAI）对收缩功能正常的高血压患者左心室舒张功能不全的诊断价值。方法346例左心室收缩功能正常的高血压患者，常规超声心动图测量左心房内径（LAD）和左心房面积（LAA），计算左心房内径指数（LADI）和LAAI；脉冲及组织多普勒分别测量二尖瓣口舒张早期血流峰速度（E）及二尖瓣环舒张早期运动峰速度（Em），计算LVFP。根据LVFP分为左心室舒张功能不全组[LVFP〉15mmHg（1mmHg=0．133kPa），n=81]和左心室舒张功能正常组（LVFP≤15mmHg，n=265），比较两组超声心动图参数，对左心房参数与LVFP行相关分析，采用ROE曲线分析左心房参数对左心室舒张功能不全的诊断价值。结果与舒张功能正常组比较，舒张功能不全组左心房较大[LADI：（21．4±2．6）mm／m^2比（19．6±24）ram／m^2；LAAI：（12．1±2．6）cm^2／m^2比（10．4±1．7）cm^2／11,12，P均〈0．01]，左心房参数均与LVFP呈正相关，其中LAAI相关系数最大（r=0．450，P〈0．01）；ROE曲线分析显示，以LAAI≥11．4cm^2／m^2为截点，诊断左心室舒张功能不全（LVFP〉15mmHg）的敏感性为63％，特异性为74％，准确性为72％。结论左心室收缩功能正常的高血压患者左心房增大与LVFP增高有关，LAAI对检测LVFP增高的价值优于LADI，在缺乏组织多普勒时，LAAI可辅助用于左心室舒张功能不全的诊断。

英文摘要：

Objective To investigate the correlation between left atrial size and left ventricular filling pressure （LVFP） and the value of left atrial size assessment on detecting diastolic dysfunction in hypertensive patients with preserved LVEF by echocardiography. Methods Echocardiography was performed in 346 hypertensive patients with preserved LVEF （ t〉 50% ）, left atrial size including left atrial diameter （LAD） and left atrial area （LAA） was measured and indexed to body surface area （LADI, I_AM）. The ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity （E/Era） was determined and LVFP was calculated with the formula： LVFP = 1.24 × E/Era ＋ 1.9. Patients were divided into diastolic dysfunction group [DD group, LVFP 〉 15 mm Hg（ 1 mm Hg =0. 133 kPa）, n = 81 ] and normal diastolic function group （NDF group, LVFP ≤ 15 mm Hg, n = 265 ）. Results As compared to patients in NDF group, the patients in D D group had larger LA [ LADI： （21.4 ± 2. 6） mm/m^2 vs. （19. 6 ± 2.4） mm/m^2 ; LAAI ： （ 12. 1 ± 2. 6） cm^2/m^2 vs. （ 10. 4 ± 1.7） cm^2/m^2 ; all P 〈 0. 01 ]. LA size parameters were positively correlated with LVFP （r=0. 211 -0. 450, all P 〈0. 01 ）, LAAI was best correlated with LVFP （r =0. 450, P 〈0.01）. ROC analysis showed that LAAI ≥11.4 cm^2/m^2 diagnosed DD with a sensitivity of 63%, specificity of 74% and accuracy of 72%. Conclusion Left atrium dilation correlates positively with LVFP in hypertensive patients with preserved LVEF. The LAAI is a more accurate parameter for identifying patients with diastolic dysfunction in this cohort.