左房容积指数与血清氨基末端脑钠肽前体在评价原发性高血压左室舒张功能不全中的作用

The effect of LAVI and NT-proBNP in the evaluation of essential hypertensive left ventricular diastolic dysfunction

目的:探讨左房容积指数(left atrial vo lume index,LAVI)与氨基末端脑钠肽前体(N-terminal B-type natriuretic peptide precursor,NT-pro BNP)在评价原发性高血压(essential hypertension,EH)左室舒张功能不全中的作用。方法:将68例EH患者按左室舒张功能分为正常(E/A>1、Em/Am>1)、早期舒张功能不全(E/A<1、Em/Am<1)、假性正常化(E/A>1、Em/Am<1)和限制性充盈(E/A>2、Em/Am<1),依次设为组1、2、3、4。同时选择健康体检者40例作为对照组,分别获取LAVI及NT-pro BNP值。结果:(1)LAVI的比较:组1与对照组比较差异无统计学意义(P>0.05),其余各组均显著高于对照组(P<0.01)。高血压组内比较:组3显著高于组1和组2(P<0.01),组4显著高于组1、组2和组3(P<0.01),组2高于组1(P<0.05)。(2)lg NT-pro BNP比较:组1、2与对照组比较差异无统计学意义(P>0.05)。组3、4均显著高于对照组(P<0.01)。高血压组内比较:组4显著高于组1、组2和组3(P<0.01),余组间比较差异无统计学意义(P>0.05)。(3)相关性分析表明,EH患者LAVI值与lg NT-pro BNP与左室舒张功能分级之间呈正相关(r=0.569,P<0.01)。(4)当LAVI=29.04 m L/m2、lg NTpro BNP=2.065 pg/m L时,敏感性+特异性的阳性值最高。结论 :LAVI水平及NT-pro BNP浓度随着EH左室舒张功能的降低而升高,二者具有较好的相关性,能较好评价EH左室舒张功能变化。

Objective: To investigate the the effect of left atrial volume index(LAVI) and N-terminal B-type natriuretic peptide precursor( NT- pro BNP) in the evaluation of essential hypertensive left ventricular diastolic dysfunction. Methods :According to the results of S.R.Ommen et al, 68 patients with essential hypertension were divided into normal(1<E/A<2, Em/Am>1), early diastolic dysfunction(E/A<1, Em/Am<1), pseudonormal(E/A >1, Em/Am <1), and restrictive filling(E/A >2, Em/Am<1), and set them to group 1, 2, 3, 4. We chose 40 healthy subjects as control group. LAVI and NT-pro BNP value were measured in each group. Results:(1)Comparison of LAVI: There was no significant difference between group 1 and control group(P>0.05). The other groups were significantly higher than those in the normal control group( P <0.01). Comparison of hypertensive group: The LAVI of group 3 was significantly higher than that of group 1,2(P<0.01). The LAVI of group 4 was significantly higher than that of group 1, 2, 3(P<0.01). The LAVI of group 2 was higher than that of group 1(P<0.05).(2)The comparison of NT-pro BNP: There was no significant difference between the group 1,2 and the control group(P>0.05). The level of NT-pro BNP of group 3,4 were significantly higher than that of the control group(P<0.01). Comparison of hypertensive group: The level of NT-pro BNP of group 4 was significantly higher than that of group 1,2,3(P<0.01). There was no significant difference between the other groups(P>0.05).(3)Correlation analysis showed: In patients with hypertension. There was positive correlation between LAVI value and lg NT-pro BNP and left ventricular diastolic functional classification level(r=0.569, P<0.01).(4)LAVI =29.04 m L/m2, lg NT-pro BNP =2.065 pg/m L, the sum of positive value of sensitivity and specificity was highest.Conclusion: The level of LAVI and NT-pro BNP concentration increased with a decrease of essential hypertensive left ventricular diastolic, they had a good correlation and evaluated essential hypertensive left ventricular diastolic dysfunction well.