高血压伴心功能不全患者的BNP、Hcy和hs-CRP表达及临床意义

Expressions and Clinical Significances of BNP,Hcy and hs-CRP in Patients with Hypertension Associated by Cardiac Insufficiency

目的探讨高血压伴心功能不全患者血清脑钠肽(BNP)、同型半胱氨酸(Hcy)和超敏C反应蛋白(hsCRP)的表达与临床意义。方法选取2014年1月—2015年8月收治的160例单纯高血压(A组)、160例高血压伴心功能不全(B组)患者作为研究对象,同时选取同期160例健康体检者(C组)作为对照。分别检测3组受试者的血清BNP、Hcy和hs-CRP水平,同时比较B组患者血清BNP、Hcy和hs-CRP水平与左心室射血分数(LVEF)的相关性。结果 A和B组的BNP、Hcy、hs-CRP水平均明显高于C组,B组又明显高于A组(P<0.01)。随着心功能分级的升高,B组患者的血清BNP、Hcy和hs-CRP水平呈明显上升趋势(P<0.01)。血清BNP、Hcy、hs-CRP水平与LVEF呈负相关(r=-0.741、-0.628和-0.462,P均<0.01),血清Hcy、hs-CRP水平与BNP水平呈正相关(r=0.821和0.429,P均<0.01)。结论高血压伴心功能不全患者血清BNP、Hcy、hs-CRP水平与心功能分级明显相关,可作为高血压伴心功能不全患者病情评估及预后判断的重要指标。

Objective To investigate expressions and clinical significances of serum brain natriuretic peptide（ BNP）,homocysteine（ Hcy） and high sensitive C reactive protein（ hs-CRP） in patients with hypertension associated by cardiac insufficiency. Methods A total of 160 patients with simple hypertension and another 160 patients with hypertension associated by cardiac insufficiency treated during January 2014 and August 2015 were selected as group A and group B respectively,and at the same period,160 healthy person taking medical examination were selected as group C. Serum levels of BNP,Hcy and hs-CRP were detected in three groups,and the correlation between serums BNP,Hcy,hs-CRP and left ventricular ejection fraction（ LVEF） in group B were analyzed. Results Serum levels of BNP,Hcy and hs-CRP in group A and B were significantly higher than those in group C,and the levels in group B were significantly higher than those in group A（ P〈0. 01）. In group B,serum levels of BNP,Hcy and hs-CRP were significantly increased with rising cardiac function classification（ P〈0. 01）; serum levels of BNP,Hcy and hs-CRP were negatively correlated with LVEF（ r =-0. 741,-0. 628 and-0. 462,P〈0. 01）,but serum levels of Hcy and hs-CRP were positively correlated with BNP level（ r = 0. 821,0. 429; P〈0. 01）. Conclusion Serum levels of BNP,Hcy and hs-CRP are significantly correlated with cardiac function in patients with hypertension and cardiac insufficiency,so the levels can be used as important indexes for evaluating the severity and prognosis of hypertension patients with cardiac insufficiency.