高血压患者血浆脑钠肽与心功能指标的相关性研究

Correlation of Plasma Brain Natriuretic Peptide with Heart Function in Hypertension

目的研究高血压患者血浆B型脑钠肽(BNP)水平与超声心动图指标、心电图V1导联P波终末电势(PtfV1)的相关性。方法将147例门诊及住院患者分为高血压1级(10例)、高血压2级(21例)、高血压3级(39例)、高血压伴舒张性心衰(DHF,42例)、高血压舒张伴收缩性心衰(DHF+SHF,35例)5组,同时选取35名健康者为对照组。测定血浆BNP水平,利用超声心动图测定每组左室射血分数(LVEF)、左室舒张末期内径(LVEDD)及左房内径(LAD),常规描记12导联心电图并计算V1导联P波终末电势,对结果进行统计学处理。结果 BNP水平在高血压3级与正常对照组、高血压1级、高血压2级,高血压伴DHF组与其他各组,高血压DHF+SHF组与其他各组之间差异有统计学意义(P<0.05)。随着高血压级别增加和心功能恶化,BNP水平呈逐渐上升趋势。血浆BNP值与左室射血分数(LVEF)呈负相关性(r=-0.767,P<0.01),与LVEDD呈正相关(r=0.642,P<0.01),BNP水平与LAD呈正相关(r=0.706,P<0.01),与PtfV1呈负相关(r=-0.623,P<0.01)。结论临床上对高血压患者进行血浆BNP水平测定,结合超声心动图测定指标、心电图V1导联P波终末电势,有助于了解高血压患者心脏损害程度,诊断舒张性心衰和对心功能进行综合评估。

Objective To investigate the correlation of plasma B-type natriuretic peptide（BNP） level with echocardiographic heart functional parameters and P wave terminal force V1（PtfV1） in essential hypertension.Methods One hundred and forty-seven hypertensives were divided into five groups：Grade 1 hypertensive group（n=10）,grade 2 hypertensive group（n=21）,grade 3 hypertensive group（n=39）,diastolic heart failure group（n=42）,diastolic and systolic heart failure group（n=35）.Thirty-five healthy individuals were as controls（n=35）.The plasma BNP levels were determined.Left ventricular ejection fraction（LVEF）,left ventricular end-diastolic diameter（LVEDD）,left atrial diameter（LAD）were examined by echocardiography.PtfV1 was measured by electrocardiogram.Results There were significant difference in plasma BNP in grade 3 hypertensive group compared with control group,grade 1 hypertensive group,grade 2 hypertensive group（P0.05）.The plasma BNP levels were elevated with the increase of hypertension degree and the degree of heart failure.The plasma BNP level were negatively correlated with LVEF（r=-0.767,P0.01）,and positively correlated with LVEDD（r=0.642,P0.01）.The plasma BNP levels were positively correlated with LAD（r=0.706.P0.01）,and negatively correlated with PtfV1（r=-0.623,P0.01）.Conclusion Plasma BNP level with echocardiographic heart functional parameters and Ptf V1 were helpful for comprehensive assessment of left heart function in essential hypertension.