原发性高血压患者左心室功能障碍与血清脑利钠肽水平的研究

Left Ventricular Dysfunction and Serum Brain Natriuretic Peptide Levels in Patients with Essential Hypertension

目的 探讨原发性高血压 (EH)患者左心室功能障碍 (LVD)与血清脑利钠肽 (BNP)水平的关系。方法用酶联免疫吸附法 (ELISA)方法检测 65例EH患者的血清BNP 3 2浓度 ,分为 4组 ,第 1组 :左心室功能正常且无左心室肥厚 (LVH) 18例 ;第 2组 :左心室功能正常但有LVH 16例 ;第 3组 :有LVD但无LVH 15例 ;第 4组 :即有LVH也有LVD 16例 ;并与健康成人3 0例作为正常对照组。结果 (1) 1～ 4组、对照组的BNP水平分别为 (112 .8± 3 6 5)ng/L、(114 8± 41 2 )ng/L、(82 5 6±3 16 8)ng/L、(83 9 6± 3 4 2 4)ng/L和 (10 9 3± 3 7 6)ng/L。 3组和 4组的BNP水平分别显著高于 1组、2组与对照组 ,差异有显著性 (P <0 0 1) ;1组和 2组与对照组、1组与 2组、3组与 4组比较差异无显著性 (P >0 0 5)。 (2 )LVD患者中BNP水平在心功能不同分级之间有显著差异 ,与NYHA分级呈正相关 (r=0 73 5,P <0 0 1)。 (3 )血清BNP水平与EH患者年龄、性别、收缩压、舒张压、脉压、左室重量指数之间无明显相关。结论 高血压病合并左心室功能障碍的病人血清BNP水平显著升高而且与心功能分级呈正相关 。

Objective To investigate the relation between left ventric ular dysfunction (LVD) and serum brain natriuretic peptide (BNP) levels in patients with essential hypertension (EH). Methods ELISA method was use d to measure the serum levels of BNP-32 in 65 patients with EH and 30 healthy subjects served as control group. 65 patients were categorized into four groups. Group 1:18 patients with EH, norma l left ventricular function and without left ventricular hypertrophy(LVH); group 2: 16 patients with EH, normal left ventricular function and LVH; group 3: 15 patients with EH, LVD and without LVH; group 4:16 patients with EH, LVD and LVH. Results (1)The serum levels of BNP were group 1(112 8±36 5) ng/L, group 2(114 8±41 2) ng/ L, group 3(825 6±316 8) ng/L, group 4(839 6±342 4) ng/L and control(109 3±37 6) ng/L(P <0 01). BNP levels in group 3 and group 4 were higher than that in group 1, group 2 and control group respectively (P<0 01). (2)The serum BNP level positively correlation with NYHA class in EH patients with LVD (r=0 735, P<0 01). (3)The serum BNP levels in EH patients had no relation to age, gender, systolic blood pressure, diastolic blood pressure, pulse pressure and left ventricular mass index. Conclusions The levels of BNP increase significantly in EH patients with established LVD and positively correlated with the NYHA classes. The BNP level was not increased in LVH with normal left ventricular function in EH patients.