血浆脑钠素浓度与高血压病患者左心室肥厚及左心室舒张功能的关系

The correlation between the levels of brain natriuretic peptide and left ventricular diastolic function as well as left ventricular hypertrophy in patients with hypertension

目的观察高血压病患者左心室肥厚(LVH)与血浆脑钠素(BNP)浓度的关系,并研究依那普利治疗前后LVH及左心室舒张功能不全的变化情况。方法高血压患者70例,平均年龄(71±10)岁,其中伴LVH组30例、无LVH组40例,正常对照组30例,高血压病患者予以依那普利10～20mg/d治疗30周。所有对象行超声心动图测定左心室质量指数(LVMI),E/A比值;采用放射免疫分析方法测定血浆BNP水平,对BNP与LVMI、E/A比值作相关分析。结果高血压病伴LVH组的血浆BNP水平明显高于无LVH组和正常对照组[(201±52)与(91±23)、(37±14)ng/L(P<0.01)],经依那普利治疗后高血压病伴LVH组血浆BNP水平明显下降[(201±52)与(65±22)ng/L(P<0.01)]和LVWI[(143±22)与(116±11)g/m2(P<0.01)],E/A比值显著提高[(0.6±0.3)与(1.0±0.4)(P<0.05)]。BNP与LVMI呈正相关(r值分别为0.43、0.41,P<0.01),与E/A比值呈负相关(r值分别为-0.65、-0.62,P<0.01)。结论血浆BNP浓度能较好地反映高血压病患者LVH及左心室舒张功能状态。

Objective To investigate the relationship between the levels of brain natriuretic peptide（BNP）and left ventricular hypertrophy（LVH）in patients with hypertension,and to observe the changes of plasma levels of BNP and left ventricular mass index（LVMI）before and after treated with enalapril.Methods 70 patients with hypertension（mean age：71.0±10.4 years）were randomly divided into LVH group（n=30）and non-LVH group（n=40）.In addition,30 healthy subjects（mean age：68.0±9.7 years）were enrolled as control group.The patients with hypertension were treated with enalapril 10-20 mg/d for 30 weeks.Echocardiography was performed to detect LVMI and E/A ratio,and the levels of plasma BNP were detected by RIA.Results The plasma BNP levels were significantly increased in LVH group,as compared with those in non-LVH group and health subjects（201.2±52.0 vs 91.4±22.6,37.2±14.3ng/L,P〈0.01）.In LVH group enalapril significantly decreased plasma levels of BNP（201.2±52.0 vs 65.3±22.4 ng/L,P〈0.01）,LVWI levels（142.7±21.5 vs 116.4±11.2g/m2,P〈0.01）,and increased E/A ratio（0.6±0.3 vs 1.0±0.4,P0.05）.The plasma levels of BNP were positively correlated with LVMI,however,which were negatively correlated with E/A ratio.Conclusion The plasma BNP levels can be used to assess the extent of left ventricular hypertrophy and diastolic function in patients with hypertension