血浆脑利钠肽与原发性高血压靶器官损害的相关性研究

The Correlation between Plasmic Brain Natriuretic Peptide and Essential Hypertension(EH) Target-organ Damage

目的探讨血浆脑利钠肽(BNP)与原发性高血压靶器官损害的关系.方法选择83例未经系统治疗的原发性高血压(EH)患者和20例正常对照,根据高血压患者是否合并靶器官损害(TOD)将原发性高血压患者分为2组:即单纯EH组(不合并靶器官损害)15例、原发性高血压合并靶器官损害组68例(合并靶器官损害患者再细分为左室肥厚、血管损害即颈动脉壁增厚、动脉粥样硬化斑块形成等、肾脏损害、脑卒中亚组,其中左室肥厚组30例、血管损害组10例、肾脏损害组10例、脑卒中组18例).对入选者均进行血压、血糖、血脂水平、肝功、肾功、尿白蛋白、十二导联心电图、超声心动图、颈动脉超声、头颅CT或MRI等检查.所有受试者均采用酶联免疫法(ELISA)测定血浆脑利钠肽(BNP)的浓度.结果 (1)原发性高血压组血浆BNP水平较正常对照组明显升高,差异有统计学意义(P<0.05);(2)原发性高血压合并靶器官损害各亚组血浆BNP水平均高于单纯高血压组和正常对照组,差异有统计学意义(P<0.05).而原发性高血压合并靶器官损害各亚组间血浆BNP水平比较,差异无统计学意义(P>0.05);(3)血浆BNP水平与LVMI(左室质量指数)呈显著正相关,相关系数为0.693(P<0.01);与LVEF(左室射血分数)呈显著负相关相关系数为-0.768(P<0.01).结论BNP与高血压及其靶器官损害的发生、发展有关,可作为判断原发性高血压病诊疗过程中的一项无创生化指标.通过对原发性高血压及合并靶器官损害的病人检测其BNP含量的变化,以此对其病情及预后进行评估,进而指导临床治疗,有着积极的意义.

Objective To investigate the association between plasmic Brain Natriuretic Peptide （BNP） and essential hypertension （EH） Target-organ Damage. Methords We studied 83 never-treated patients with essential hypertension and 20 normal subjects. Hypertensive patients were divided into two groups, one group was 68 patients with target-organ damage and the other was 15 patients without target-organ damage （pure hypertensive patients） . Then 68 patients with TOD were subdivide into subgroups： with 30 left ventricular hypertrophy （LVH）, 10 carotid artery wall thickening, 10 renal damage and 18 stroke. All subjects received examinations on the general situation, blood pressure, fasting plasma glucose and blood lipid levels, liver function, renal function, urinary albumin, a standard 12-lead ECG, 24-hour blood pressure, echocardiography, carotid ultrasonography and cerebral CT or MRI so on. The plasmic BNP levels were measured by Enzyme-linked immunosorbent assay （ELISA） . Results （1） The plasma levels of BNP were elevated in the essential hypertension （EH） group than normal subjects （P〈0.05） . （2） The plasma BNP levels in essential hypertension with target organ damage in each subgroup were higher than in pure essential hypertension group and normal control group, the differences were statistically significant （P〈0.05） . And the plasma BNP levels comparison among various subgroups of essential hypertension with target organ zamage, there were no statistically significant difference （P〉0.05） （3） In patients with LVH correlation analysis showed that： The plasma level of BNP had positive correlation with left ventricular mass index （LVMI） （r=0.693, P〈0.01）, had negative correlation with LVEF （r=-0.768, P〈 0.01） Conclusions BNP is correlated to the occurrences and developments of essential hypertension and target-organ damage, may become a no-traumatic laboratory indicator in the process of essential hypertension diagnosis and treatment. It has a positive meaning in the disease of changes and prognosis assessment to guide clinical treatment through measuring BNP levels in patients with hypertension and target-organ damage.