高血压伴LVH心力衰竭的Apelin测定分析

Clinical Significance of the Plasma Apelin in Essential Hypertension Patients with LVH and Heart Failure

目的：研究原发性高血压伴LVH心力衰竭患者治疗前后血浆Apelin的水平，探讨原发性高血压伴LVH早期心衰与血浆Apelin的关系。方法：选取原发性高血压伴LVH无心衰患者66例（无心衰组），原发性高血压伴LVH早期心衰（ NYHA心功能分级Ⅰ～Ⅱ级）患者65例（早期心衰组），选取经体检筛查身体健康的中老年体检者30例作为正常组（对照组）。用双抗体夹心法分别测定3组患者血浆Apelin水平和血浆N末端脑钠肽原（NT-proBNP）含量，用超声仪测量左室射血分数（LVEF）。结果：对照组EF、NT-proBNP 和无心衰组、早期心衰组比较有显著性差异（P＜0.05），无心衰组和早期心衰组比较有显著性差异（P＜0.05）；无心衰期组血浆Apelin水平分别低于对照组和早期心衰组，早期心衰组Apelin水平高于对照组，有显著性差异；无心衰组及早期心衰组患者Apelin水平与EF 呈正相关，而无心衰组患者Apelin水平与proBNP呈负相关。无心衰组治疗后的Apelin水平较治疗前高，早期心衰组治疗后的Apelin的水平较治疗前下降，但无显著性差异（ P＞0.05），提示血压下降、心功能改善与血浆Apelin水平相关，但不同组别降压方法对患者血浆Apelin的水平均无明显影响。结论：血浆Apelin水平在高血压伴LVH时降低，当出现早期心衰时上升，监测Apelin水平可预测心衰的发生，Apelin可作为观察心功能状况和预后的辅助指标。

Objective：To study plasma Apelin level before and after the treatment of primary hypertension patients with LVH and heart failure ;to discuss the relationship between plasma Apelin with essential hypertension ,LVH,early heart failure. Methods：Selected 66 essential hypertension patients with LVH without heart failure , 65 essential hypertension patients with LVH and early heart failure （ NYHA Cardiac function classification Ⅰ -Ⅱ） , and 30 healthy people as the normal control group . Measured patients ’ plasma Apelin level and the content of Plasma N -terminal pro-brain natriuretic peptide （ NT-proBNP） with the double antibody sandwich method ,and measured the left ventricle ejection fraction （ LVEF） with ultrasound.Results：There were statistically significant difference between the control group and the group without heart failure ,the group with heart failureon EF, NT-proBNP（P〈0.05）; there was also statistically significant difference between the group without heart failure and the group with early heart failure;the plasma Apelin level of the group without heart failure was lower than that of the control group and the group with early heart failure;the plasma Apelin level of the group with early heart failure was lower than that of the control group, which showed statistically significant difference;the plasma Apelin level of the group without heart failure and the group with early heart failure was positively related to EF , while the plasma Apelin level of the group without heart failure was negatively related to proBNP .After treatment , the plasma Apelin level of the group without heart failure became higher than before,and the plasma Apelin level of the group with early heart failure became lower than before .However,the difference was not statistically significant （ P〉0.05 ） .The fall of blood pressure and the improvement of heart function were related to the plasma Apelin level , but in different groups , the antihypertensive methods had no significant influence to the plasma Apelin level .Conclusion：Patients’ plasma Apelin level becomes lower following hypertension with LVH ,and becomes higher following early heart failure .Monitoring Apelin levels can predict the occurrence of heart failure ,and Apelin can be used as an auxiliary index to bserve the condition and prognosis of heart function .