原发性高血压患者血清可溶性ST2及N末端B型利钠肽水平与左心室肥厚的关系

Relationship Between the Levels of Soluble ST2,N-Terminal Pro-B-type Natriuretic Peptide and Left Ventricular Hypertrophy in Patients with Essential Hypertension

目的探讨原发性高血压(EH)患者血清可溶性生长刺激表达基因2蛋白(sST2)及N末端B型利钠肽(NT-proBNP)水平与左心室肥厚(LVH)的关系。方法选取2020年4月至2021年6月在郑州大学第一附属医院住院的228例EH患者,根据是否合并左心室肥厚分为LVH组(76例)和非LVH组(152例),选取同期健康体检者107例为对照组。对EH组中左心室肥厚指数(LVMI)与血清sST2及NT-proBNP水平进行相关性分析,采用多因素logistic回归分析及受试者工作特征(ROC)曲线探讨血清sST2及NT-proBNP水平与LVH的关系及其对LVH的预测价值。结果LVH组、非LVH组及对照组在BMI、收缩压、舒张压、肌酐、sST2及NT-proBNP水平、左房内径、左室内径方面比较,差异有统计学意义(P<0.05)。LVH组患者sST2及NT-proBNP水平均高于非LVH组(P<0.05)。EH组LVMI分别与血清sST2及NT-proBNP水平呈正相关(r=0.361、0.195,P<0.05)。血清sST2预测EH患者发生LVH的ROC曲线下面积为0.731(95%CI:0.665~0.797),高于NT-proBNP曲线下面积0.618(95%CI:0.542~0.694)。logistic回归分析显示血清sST2及NT-proBNP水平是影响LVH发生的独立危险因素。结论血清sST2及NT-proBNP水平是预测EH患者发生LVH的重要指标。

Objective To investigate the relationship between soluble growth stimulation expressed gene 2(sST2),N-terminal pro-B-type natriuretic peptide(NT-proBNP)and left ventricular hypertrophy(LVH)in patients with essential hypertension(EH).Methods A retrospective analysis of 228 in patients with EH in the Department of Cardiology of the First Affiliated Hospital of Zhengzhou University from April 2020 to June 2021 were performed.EH patients were divided into LVH group(76 cases)and non-LVH group(152 cases)according to the criteria of LVH.One hundred and seven healthy individuals who underwent health screening in the same period were as control group.The correlations between left ventricular mass index(LVMI)and serum levels of sST2 and NT-proBNP in EH group were analyzed.Multivariate logistic regression analysis and receiver operating characteristic(ROC)curve were used to explore the relationship between serum levels of sST2 and NT-proBNP and LVH,and their predictive value for LVH.Results There were statistical differences in terms of BMI,systolic blood pressure,diastolic blood pressure,serum creatinine,sST2,NT-proBNP,left atrial diameter and left ventricular end-diastolic dimension among three groups(P<0.05).The serum concentrations of sST2 and NT-proBNP in LVH group were higher than those in non-LVH group(P<0.05).LVMI was positively correlated with serum sST2 and NT-proBNP concentrations in EH group(r=0.361,0.195,P<0.05).The area under ROC curve for serum sST2 to predict LVH in EH patients was 0.731(95%CI:0.665-0.797),which was higher than 0.618(95%CI:0.542-0.694)under NT-proBNP curve.In the logistic regression analysis,serum sST2 and NT-proBNP concentrations were independent risk factors of LVH.Conclusion Serum sST2 and NT-proBNP levels are important indicators for predicting LVH in EH patients.