联合测定NT-proBNP、hs-CRP及Tei指数评价老年高血压患者左室重构和心功能

Feasibility of NT-proBNP,hs-CRP and Tei Index in Assessing Left Ventricular Remodeling and Cardiac Function in Elderly Hypertensive Patients

目的:探究联合测定血浆N末端前脑钠肽(N-terminal B-type natriuretic peptide,NTpro BNP)、超敏C-反应蛋白(High sensitivity c-reactive preotein,hs-CRP)及Tei指数评价老年高血压患者左室重构和心功能的可行性。方法:选取2016年3月-2017年3月本院住院的老年原发性高血压患者80例和对照组(正常人)40例,其中高血压患者分为2个亚组,无左心室肥厚组(Left ventricular hypertrophy,LVH)(高血压Ⅰ组)和伴LVH组(高血压Ⅱ组),每组各40例。测定并比较三组患者左心室质量指数(LVMI)、Tei指数和NT-pro BNP和hs-CRP水平。结果:高血压Ⅰ组患者LVMI与对照组比较,差异无统计学意义(P>0.05);而Tei指数、血浆NT-pro BNP、hs-CRP比较,差异均有统计学意义(P<0.05);高血压Ⅱ组患者LVMI、Tei指数、血浆NT-pro BNP、hs-CRP与对照组比较,差异均有统计学意义(P<0.05);高血压Ⅱ组患者Tei指数、血浆NT-pro BNP、hs-CRP水平均较高血压Ⅰ组升高更加明显(P<0.05)。结论:NT-pro BNP、hs-CRP及Tei指数是评价老年高血压患者左室重构和心功能的重要指标,为探索老年高血压患者LVH和伴有心功能不全患者早期诊断提供了科学依据,同时更早地提供了相关临床决策和理论依据,减少心血管病发生率,为老年高血压患者带来了福音,也为整个社会带来一定的社会效益和经济效益。

Objective:To explore the feasibility of combined determination of plasma NT-proBNP,hs-CRP and Tei index in evaluation of left ventricular remodeling and cardiac function in elderly patients with hypertension.Method:80 elderly patients with essential hypertension from March 2016 to March 2017 in our hospital and 40 normal subjects(control group)were selected,the hypertension patients were divided into 2 subgroups,without LVH group(hypertension groupⅠ)and with LVH group(hypertension groupⅡ),40 cases in each group.The left ventricular mass index(LVMI),Tei index and the levels of NT-proBNP and hs-CRP were measured and compared between three groups.Result:The LVMI of hypertension groupⅠwas compared with control group,the difference was not statistically significant(P>0.05),but the Tei index,plasma NT-proBNP and hs-CRP were compared,the differences were statistically significant(P<0.05);The LVMI,Tei index,plasma NT-proBNP and hs-CRP of hypertension groupⅡwere compared with control group,the differences were statistically significant(P<0.05).The Tei index,plasma NT-proBNP and hs-CRP levels in hypertension groupⅡwere more obvious than those in hypertension groupⅠ(P<0.05).Conclusion:NT-proBNP,hs-CRP and Tei index are important indexes to evaluate left ventricular remodeling and cardiac function in elderly patients with hypertension,provide scientific basis for early diagnosis of LVH and cardiac dysfunction in elderly patients with hypertension,and earlier provides relevant theoretical basis and clinical decision making,reduce the incidence of cardiovascular disease,the gospel for the elderly patients with hypertension,but also for the whole society to bring some social and economic benefits.