高血压左心室肥厚患者血浆内皮素-1、氨基末端脑钠肽前体浓度的变化及意义

Changes and Significance of Plasma Endothelin-1,N-Terminal Pro-Brain Natriuretic Peptide Concentration in Patients with Hypertensive Left Ventricular Hypertrophy

目的:探讨血浆内皮素-1(ET-1)、氨基末端脑钠肽前体(NT-proBNP)与高血压左心室肥厚间的潜在联系,及其对高血压左心室肥厚的诊断价值。方法:对原发性高血压左心室肥厚(LVH)患者50例,健康对照组50例,采用酶联免疫吸附法检测血浆ET-1及NT-proBNP的浓度,并通过绘制ROC曲线制定ET-1、NT-proBNP对高血压左心室肥厚的诊断界值。结果:原发性高血压LVH患者血浆ET-1、NT-proBNP浓度均较正常对照组显著升高(P<0.01)。通过绘制ROC曲线发现:以ET-1作为高血压LVH的诊断指标,最佳临界值为279.9pg/ml,所对应的灵敏度为97%,特异度为79%;以NT-proBNP作为高血压LVH的诊断指标,最佳临界值为32.6pg/ml,所对应的灵敏度为64%,特异度为93%。结论:血浆ET-1、NT-proBNP水平与高血压LVH密切相关。血浆ET-1、NT-proBNP水平对高血压左心室肥厚具有较高的诊断效能。

Objective ：To explore the potential relationship between plasma endothelin-1 （ET-1） ,N-ter-minal pro-brain natriuretic peptide（NT-proBNP） and hypertensive left ventricular hypertrophy （LVH） ,and evaluate the diagnostic value of plasma ET-1、NT-proBNP to hypertensive LVH .Method：Fifty hypertensive patients with LVH （27 males and 23 females） and Fifty healthy subjects （27 males and 23 females） were included in this study . The concentration of plasma ET-1 ,NT-proBNP of two group were measured by ELISA method .Comparing the difference of plasma ET-1 and NT-proBNP concentration between two groups ,and drawing ROC curves to evaluate the diagnostic value of ET-1 and NT-proBNP to hypertensive LVH .Results ：The plasma ET-1 ,NT-proBNP concen-trations in hypertensive LVH group were significantly higher than those in control group （P＆lt;0 .01） .Utilizing ET-1 as hypertensive LVH diagnostic index ,the best cutoff value was 279 .9 pg/ml ,its corresponding sensitivity and spe-cificity were 97% and 79% separately ;utilizing NT-proBNP as hypertensive LVH diagnostic index ,the best cutoff value was 32 .6 pg/ml ,its corresponding sensitivity and specificity were 64% and 93% separately .Conclusion ：The plasma ET-1 and NT-proBNP concentration are closely related to hypertensive LVH .The plasma ET-1 ,NT-proB-NP concentration has high diagnostic efficacy to hypertensive left ventricular hypertrophy .