原发性高血压患者左心室舒张功能障碍与微量白蛋白尿的关系研究

Relationship between left ventricular diastolic dysfunction and microalbuminuria in primary hypertension

目的探讨原发性高血压患者左心室舒张功能障碍与微量白蛋白尿(UM)的关系。方法选择未经药物治疗的原发性高血压[24h平均收缩压>140mm Hg和(或)舒张压>90mm Hg]患者106例,并按照左心室舒张功能是否正常分为舒张功能正常组40例及舒张功能障碍组66例,比较两组收缩压(SBP)、舒张压(DBP)、射血分数(EF)、舒张期左心室后壁厚度(LVPWd)、舒张期室间隔厚度(IVSd)、N末端脑钠肽前体(NT-proBNP)及UM水平。采用logistic回归分析影响左心室舒张功能障碍的相关因素。结果舒张功能障碍组SBP、DBP、LVPWd、LVSd、UM均高于正常组,差异均有统计学意义(P<0.05),两组NT-proBNP无明显差异(P>0.05)。UM是心脏舒张功能障碍的独立危险因素(P<0.05)。结论原发性高血压伴左心室舒张功能障碍患者,UM在NT-proBNP升高前已明显升高,UM可作为原发性高血压患者左心室舒张功能障碍的早期标志物。

Objective To explore the relationship between left ventricular diastolic dysfunction and microalbuminuria in primary hypertension. Methods One hundred and six patients with newly diagnosed primary hypertension,including 40 cases of normal cardiac diastolic function(normal group)and 66 cases of abnormal cardiac diastolic function(abnormal group)were enrolled in the study.The systolic blood pressure(SBP),diastolic blood pressure(DBP),ejection fraction(EF),left ventricular posterior wall thickness(LVPWd),interventricular septum thickness at end-diastole(IVSd)serum N-terminal pro-B-type natriuretic peptide(NT-proBNP),and urinary microalbumin(UM)were measured and compared between two groups.Logistic regression analysis was used to examine the related factors of diastolic dysfunction. Results For abnormal group,the SBP,DBP,LVPWd,IVSd and UM was significantly higher than those for normal group.There were no significant differences in other indicators between two groups.UM is related to diastolic dysfunction. Conclusion UM rises early than the NT-proBNP,indicating that microalbuminuria may be an early marker of diastolic dysfunction in primary hypertension.