老年房颤伴高血压患者脑钠肽水平变化及相关因素分析

Change of brain natriuretic peptide and analysis of related factors in elderly patients with atrial fibrillation and hypertension

目的研究老年房颤（Af）伴高血压患者脑钠肽（B—typenatriureticpeptide，BNP）水平变化，心脏结构的变化，探讨高血压对于老年房颤患者预后的影响。方法选择仁济医院老年病科住院老年患者共110例（年龄79．57±5．49岁），分为j组，对照组34例（即无高血压或Af），房颤组33人（即Af不伴高血压），Af伴高血压组43例，分别行血BNP及心彩超柃查。结果房颤组的BNP，左房内径高于对照组（P分别〈0．01，O．05），老年Af伴高血压患者的BNP、左房内径、室间隔厚度、左室后壁厚度、左室重量指数高于房颤组，（P分别〈0．01，0．05，0．05，0．05，0．05），BNP分别与左房内径，室间隔厚度，左室后壁厚度，左室重量指数呈正相关。结论高血压加重了老年Af患者心脏的重构，BNP可作为老年Af伴高血压患者疾病预后的预测指标。

Objective To investigate the clinical significance of plasma brain natriuretic peptide （BNP） levels and Doppler echocardiography in patients with atrial fibrillation （Af）, essential hypertension （EH） and controls. Methods Plasma levels of BNP were measured in 43 patients with Af and EH, 33 patients with Af and 34 controls. Doppler echocardiography was performed in each patient. Results Plasma levels of BNP and LAD in patients with Af were higher than those in the controls. Plasma levels of BNP, LAD, IVSd, PWTd and LVMI in patients with AF and EH were higher than those in patients with Af. Plasma levels of BNP were correlated with LAD, IVSd, PWTd and LVMI. Conclusion EH improved the cardic remodeling of patients with Af. Plasma levels of BNP can predict the prognosis.