脑钠肽与原发性高血压左室重构相关性的临床研究

Correlation of brain natriuretic peptide with left ventricular remodeling in patients with essential hypertension

目的:比较原发性高血压患者和健康对照个体血浆脑钠肽水平的差别,研究BNP同左室重量指数的关系,从而探讨BNP与高血压性心室重构的相关性。方法:收集我院2007年-2010年住院及门诊原发性高血压患者86例,以及健康体检者31例,均行血浆BNP,血清hs-CRP,总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),尿素氮(BUN),肌酐(CR),尿酸(UA)测定,同时行彩色多普勒超声心动图检查,记录室间隔厚度(IVST),左室后壁厚度(LVPWT),左室舒张末期内径(LVEDd),左室收缩末期内径(LVEDs),EF值,根据各项超声指标,计算出左室重量及左室重量指数LVMI=LVM/BSA。LVMI=LVM/BSA。所有研究对象分为EH组及健康对照组,86例EH患者按照血压水平的不同分为EH1,EH2,EH3等3组,按照是否合并有LVMI水平增高分为单纯EH组和EH合并LVH组。结果:①EH组较健康对照组BNP水平增高,差别有统计学意义(P=0.019,P<0.05)。②EH1,EH2,EH3组两两比较,EH3组较EH1组,EH2组BNP水平增高(P=0.026,0.029,P<0.05),EH1,EH2组之间差别无统计学意义(P>0.05)。③EH合并LVH组较单纯EH组BNP水平增高(P=0.036,P<0.05)。④随着血浆BNP水平的增高,LVMI增大,二者之间呈正相关关系(r=0.591,P<0.05);BNP与UA,LVEDd呈正相关关系(r=0.355,0.423,P均<0.05)。结论:高血压患者存在BNP水平的增高;BNP可反映高血压心室重构的程度。

Objective：To compare the difference of serum brain natriuretic peptide in the patients with essential hypertension and healthiers,and to study the relationship of BNP and levels of left ventricular mass index,in order to explore the correlation between BNP and left ventricular remodeling.Methods：BNP,totalcholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,urea nitrogen（BUN）,creatinine（CR）and uric acid（UA） were measured in all the individuals,including 86 patients with EH and 31 healthyiers.At the sme time,colour doppler echocardiography was accepted;the indexes include IVST,LVPWT,LVEDd,LVEDs,EF.Then left ventricular mass index（LVMI） was BSA.All the individuals were divided into EH group and control group.And then the EH patients were divided into EH1,EH2,EH3 three groups based on blood pressure;at the same time,EH patients were divided into simple EH and EH with LVH.Results：BNP of EH group was higher than that of control group（P =0.019,P〈0.05）;EH3 had a higher level of BNP than EH1,EH2（P =0.026,0.029,P〈0.05）,but there was no difference between EH1 and EH2（P〉0.05）.There was significantly higher level of BNP in group of EH with LVH than simple EH group（P =0.036,P〈0.05）.LVMI had positive correlation with BNP,（r=0.591,P〈0.05）.BNP had positve correlation with UA,LVEDd（r=0.355,0.423,P〈0.05）.Conclusions：Patients of EH had high level of BNP.BNP could reflect the degree of left ventricular remodeling.