社区队列人群血浆氨基末端脑钠肽前体水平与左心室构型关系探讨

The relationship between N-terminal pro-brain natriuretic peptide and the left ventricular geometry types in the community cohort

目的:探讨社区队列人群血浆氨基酸末端脑钠肽前体(NT-proBNP)水平与左心室构型的关系。方法:横断面调查北京首钢社区733例具有心血管疾病高危因素的队列人群,运用电化学发光免疫技术测定血浆NT-ProBNP水平。收集人群年龄、性别、身高及体质量等一般资料,以及心血管疾病病史情况如心肌梗死、心绞痛、高血压病及心房颤动并收集有无糖尿病、脑卒中/短暂性脑缺血发作(TIA)等病史;行超声心动图检查测量有关参数,并根据舒张末期室间隔厚度(IVSTd),左心室后壁厚度(LVP-WT)及左心室内径(LVDd)等参数对受试者左心室构型进行分型分组。分析血浆NT-ProBNP水平与左心室构型的关系。结果:在校正有差异因素后,有左心室肥厚组血浆NT-ProBNP水平高于无左心室肥厚组,中位数分别为96.79 ng/L和62.74 ng/L(P=0.0001),左心室构型的分型与血浆NT-ProBNP水平相关(r=0.159,P=0.0001),以向心性肥厚型血浆NT-ProBNP水平最高,为105.4 ng/L。多因素回归分析显示,左心室构型分型为血浆NT-ProBNP水平的独立影响因素。结论:血浆NT-ProBNP水平与左心室构型有关,左心室构型是血浆NT-ProBNP水平的独立影响因素之一。

Objective：To investigate the relationship between N-terminal pro-brain natriuretic peptide and left ventricular geometry types in the community cohort.Methods：We investigated 733 subjects with high risks of cardiovascular diseases in Beijing ShouGang community.Plasma NT-proBNP level was measured with the automated electrochemiluminescence immunoassay.We collected the subjects＇ age,gender,body height and weight,history of myocardial infarction,angina pectoris,hypertension,atrial fibrillation,diabetes mellitus,and stroke or TIA.Four types of left ventricular geometry were defined according to their IVSTd,LVPWTd and LVDd.Then we analyzed the correlation between plasma NT-proBNP and left ventricular geometry types.Results：After revising the differences that the plasma NT-proBNP in the left ventricular hypertrophy group is higher than that in the normal group（96.79 ng/L vs 62.74 ng/L,P=0.000）.Furthermore,the different group with various left ventricular geometry types are in correlation with plasma NT-proBNP（r=0.159,P=0.000）,and the plasma NT-proBNP is the highest one in the concentric hypertrophy type（105.4 ng/L）.Multiple factor regression analysis shows the serum NT-proBNP independently correlated with the left ventricular geometry types.Conclusion：The serum NT-proBNP independently correlated with the left ventricular geometry types.