原发性高血压患者左心室舒张功能与血浆B型钠尿肽及组织纤维化血清指标关系的研究

Relationship between left ventricular diastolic function and the level of plasma B-natriuretic peptide and serum fibrotic indices in essential hypertension patients.

目的探讨原发性高血压患者左心室舒张功能与血浆B型钠尿肽(BNP)及组织纤维化血清指标的相互关系。方法91例原发性高血压患者均行超声心动图检查确定左心室功能状态,并排除有左心室收缩功能不全者,其中正常心功能32例,左心室舒张功能不全59例。用放免法测定血清Ⅲ型前胶原(PCⅢ)、层粘蛋白(LN)、透明质酸(HA)浓度,干式快速免疫荧光法定量测定血浆BNP浓度。结果左心室舒张功能不全者左心室质量指数(LVMI)、血浆BNP及血清PCⅢ、LN、HA水平均显著升高(P<0.01),有心力衰竭症状者升高更显著(P<0.05或0.01);血浆BNP水平与LVMI及血清PCⅢ、LN、HA水平均呈显著正相关(P<0.01)。结论血浆BNP及组织纤维化血清指标PCⅢ、LN、HA可作为评价高血压左心室舒张功能不全的客观指标。

Objective To investigate the relationship between left ventricular diastolic function and the level of plasma B-natriuretic peptide(BNP) and serum fibrotic indexes in essential hypertensive patients.Methods 91 essential hypertensive patients were referred for echocardiography to evaluate left ventricular function,while patients with abnormal systolic function were excluded,and then the patients were classified as normal cardial function group(n=32) and abnormal left ventricular diastolic function group(n=59).Serum levels of procollagen type Ⅲ(PCⅢ),laminin(LN),and hyaluronic acid(HA) were measured by radioimmunoassay,while plasma BNP levels were measured by a rapid immunofluorescence.Results The levels of plasma BNP,serum PCⅢ,LN,HA and left ventricular mass index(LVMI) in hypertensive patients with left ventricular diastolic dysfunction were significantly increasecl(P<0.01),and those in patients with heart failure were much higher(P<0.05 or 0.01).There was positive correlation between the levels of plasma BNP and the level of LVMI,serum PCⅢ,LN,and HA(P<0.01). Conclusion Plasma BNP and serum PCⅢ,LN and HA are the objective markers of left ventricular diastolic dysfunction in essential hypertensive patients.