氯沙坦对高血压左室肥厚患者血浆脑钠肽的影响

Influence of losartan on plasma level of brain natriuretic peptide in patients with hypertension complicated left ventricular hypertrophy

目的:研究氯沙坦干预对高血压伴左室肥厚患者脑钠肽(BNP)的影响及意义。方法:选择100例左室射血分数正常范围的高血压患者,其中58例伴左室肥厚,42例不伴左室肥厚,另选50例健康者作为健康对照组,比较三组间血浆BNP水平。左室肥厚组给予氯沙坦治疗6个月,比较治疗前后BNP、左室质量指数(LVMI)的变化。结果:①高血压伴左室肥厚患者BNP浓度显著高于不伴左室肥厚组及健康对照组[(62.21±9.70)pg/ml比(39.35±10.57)pg/ml比(13.89±5.34)pg/ml,P<0.01];②BNP的浓度与LVMI呈正相关(r=0.44,P<0.05);③与治疗前比较,氯沙坦治疗高血压伴左室肥厚6个月后,血浆BNP[(62.21±9.70)pg/ml比(38.78±7.94)pg/ml]、LVMI[(128.71±12.64)g/m2比(107.36±11.32)g/m2]均显著降低(P<0.01)。结论:氯沙坦可明显降低高血压伴左室肥厚患者脑钠肽水平,逆转左室肥厚。

Abstract1 Objective： To study effects of losartan on level of brain natriuretic peptide （BNP） in patients with essen- tial hypertension （EH） complicated left ventricular hypertrophy （LVH） and its significance. Methods： The 100 EH patients with normal left ventricular ejection fraction （LVEF） were selected, and there were 58 cases complicated with LVH and 42 pure EH cases. Another 50 healthy subjects were regard as healthy control group. Plasma levels of BNP were compared among the three groups. EH±LVH group were given losartan for six months, the changes of BNP level and left ventricular mass index （LVMI） were compared before and after treatment. Results： （1） Plasma lovel of BNP of EH ± LVH group was significantly higher than those of pure EH group and healthy control group [ （62, 21±9, 70） pg/ml vs. （39.35± 10.57） pg/ml vs. （13.89±5.34） pg/ml, P〈0.01];Concentration of BNP was positively correlated with LVMI （r=0.44, P〈0.05） ] （3） Compared with before treatment, there were signifi-cant decrease in plasma level of BNP [（62.21±9.70） pg/ml vs. （38.78±7.94） pg/ml] and LVMI [- （128.71± 12.64） g/m2 vs. （107.36±11.32） g/m2 in EH ± LVH group after six--month treatment with losartan, P〈0.01 both. Conclusion： Losartan can significantly decrease level of brain natriuretic peptide and reverse left ventricular hypertrophy in patients with hypertension complicated left ventricular hypertrophy.