老年原发性高血压患者BNP、hs-CRP与房颤关系的研究

Research of the relationship between brain natriuretic peptide and high-sensitivity C-reactive protein with atrial fibrillation in elderly hypertension patients

目的探讨老年原发性高血压患者血清B型利钠肽(BNP)、高敏C反应蛋白(hs-CRP)水平与心房颤动之间的关系。方法对我院2008年10月—2011年10月连续诊治的老年原发性高血压患者209例,根据超声心动图(UCG)测量左室舒张末内径(LVEDD)、室间隔厚度(IVSD)、左室后壁厚度(LVPWD)、左室射血分数(LVEF)、左房内径(LA),计算左室质量指数(LVMI)。根据ECG将患者分为房颤组(AF组,105例)及无房颤组(NAF组,104例),测定两组患者的血清BNP、hs-CRP水平。结果 AF组中阵发性房颤48例,持续性房颤24例,永久性房颤33例。AF组患者的BNP[(198.66±118.85)ng/L与(86.37±66.96)ng/L]与LVMI[(127.19±28.04)g/m2与(83.70±17.23)g/m2]明显高于NAF组(P<0.01)。永久性房颤患者BNP明显高于阵发性房颤患者[(242.45±134.36)ng/L与(178.95±102.73)ng/L,P<0.05],而阵发性房颤、持续性房颤患者BNP无统计学差异(P>0.05);三组间hs-CRP均无统计学差异(P>0.05)。老年原发性高血压房颤患者BNP与患者LVMI、LA、房颤持续时间成正相关,与LVEF成负相关。Logistic回归分析表明,老年原发性高血压患者血清BNP水平升高,房颤的可能性增大。hs-CRP与房颤之间无相关性(P>0.05)。结论 BNP与老年原发性高血压房颤之间关系密切。BNP可作为老年原发性高血压左心室心肌肥厚的标志物。

Objective To investigate the relationship between the BNP,hs-CRP levels with atrial fibrillation（AF） in elderly hypertensive patients. Methods The levels of BNP and hs-CRP in 209 elderly hypertensive patients from October 2008 to February 2011 were tested.UCG was performed for each hypertensive patient.Left ventricular mass index（LVMI） was calculated based on the left ventricular end-diastolic diameter（LVEDD）,inter-ventricular septum thickness（IVSD）,left ventricular posterior wall thickness（LVPWD）,left ventricular ejection fraction（LVEF） and left atrial diameter（LA） measured by UCG.According to the LVMI and ECG,the patients were divided into AF group（n=105） and NAF group（n=104）.The levels of plasma BNP,hs-CRP in the two groups were determined. Results In the group of patients with atrial fibrillation,there were 48 cases of paroxysmal atrial fibrillation,24 cases of persistent atrial fibrillation and 33 cases of permanent atrial fibrillation.BNP [（198.66±118.85）ng/L vs.（86.37±66.96） ng/L] and LVMI [（127.85±28.04） g/m2 vs.（83.70±17.23） g/m2] were higher in AF group than NAF group（P0.01）.The level of BNP was higher in the permanent AF patients than the paroxysmal AF patients [（242.45±134.36）ng/L vs.（178.95±102.73）ng/L,P0.05].BNP between paroxysmal atrial fibrillation and persistent atrial fibrillation showed no statistic difference（P0.05）.The difference of hs-CRP between three groups showed no statistical significance（P0.05）.LA,the time of atrial fibrillation and LVMI were positively correlated with BNP in hypertensive patients.BNP was negatively correlated with hs-CRP with the above-mentioned indicators.Logistic regression analysis showed that higher serum BNP levels in hypertensive patients could increase the possibility of atrial fibrillation.There was no relationship between hs-CRP level and atrial fibrillation（P0.05）. Conclusion BNP is closely related to AF.BNP and hs-CRP can be markers for hypertension complicated with atrial fibrillation.