H型高血压合并射血分数保留心力衰竭患者血清NT-pro BNP、hs-CRP、BUA、Hcy临床意义研究

Clinical Significance of Serum NT-pro BNP,hs-CRP,BUA and Hcy in Patients with H-type Hypertension Complicated with Ejection Fraction Preserving Heart Failure

目的:探讨H型高血压合并射血分数保留心力衰竭(HFpEF)患者血清N端脑钠肽前体(NT-pro BNP)、超敏C-反应蛋白(hs-CRP)、尿素氮(BUA)、同型半胱氨酸(Hcy)的表达特点及临床意义。方法:选取本院2015年1月~2019年1月期间收治的200例H型高血压合并HFpEF患者,记为观察组;选取同期收治的60例单纯H型高血压患者,记为对照组。检测并比较两组血清NT-pro BNP、hs-CRP、BUA、HCY表达水平。根据纽约心功能分级(NYHA)将观察组分为Ⅱ~Ⅳ亚组,比较各亚组间血清NT-pro BNP、hs-CRP、BUA、Hcy和超声心动图相关指标差异,并分析上述标间表达的相关性。结果:观察组血清NT-pro BNP、hs-CRP、BUA、Hcy水平均高于对照组,HFpEF患者上述指标检测水平以及超声心动图指标LVDd、IVST、LAV随NYHA分级增加而升高,LVEF随NYHA分级增加而下降,亚组间比较差异均有统计学意义;Pearson相关性分析显示,HFpEF患者上述血清指标和LVEF均呈负相关(r=-0.753、-0.421、-0.537、-0.628),血清NT-pro BNP与hs-CRP、BUA、Hcy均呈正相关(r=0.423、0.457、0.628)。结论:H型高血压合并HFpEF患者血清NT-pro BNP、hs-CRP、BUA、Hcy水平明显升高,且检测水平和NYHA分级、LVEF存在紧密关联,临床加强检测对优化HFpEF诊断及病情程度评估具有重要价值。

Objective To investigate the expression and clinical significance of N-terminal brain natriuretic peptide precursor(NT-pro BNP),hypersensitive C-reactive protein(hs-CRP),urea nitrogen(BUA)and homocysteine(Hcy)in patients with H-type hypertension complicated with ejection fraction preserved heart failure(HFpEF).Methods 200 patients with H-type hypertension and HFpEF admitted in our hospital from January 2015 to January 2019 were selected as observation group,and 60 patients with simple H-type hypertension admitted in the same period were selected as control group.The serum levels of NT-pro BNP,hs-CRP,BUA and HCY were detected and compared between the two groups.According to New York Heart Function Classification(NYHA),the observation group was divided into subgroups II to IV.The differences of serum NT-pro BNP,hs-CRP,BUA,Hcy and echocardiographic related indicators were compared among subgroups,and the correlation between the above-mentioned indicators was analyzed.Results The serum levels of NT-pro BNP,hs-CRP,BUA and Hcy in the observation group were higher than those in the control group.The detection level of above-mentioned indexes and echocardiographic indexes LVDd,IVST and LAV in HFpEF patients increased with the increase of NYHA grade,while LVEF decreased with the increase of NYHA grade.There were significant differences between the subgroups.Pearson correlation analysis showed that the above-mentioned blood levels in HFpEF patients had statistical significance.The serum NT-pro BNP was positively correlated with hs-CRP,BUA and Hcy(r=0.423,0.457,0.628).Conclusion The serum levels of NT-pro BNP,hs-CRP,BUA and Hcy in patients with H-type hypertension complicated with HFpEF were significantly increased,and there was a close correlation between the detection level and NYHA classification and LVEF.Strengthening the clinical detection was of great value in optimizing the diagnosis of HFpEF and evaluating the severity of HFpEF.