原发性高血压患者N端脑钠肽前体测定及其意义  

The clinical study of serum N-terminal pro-brain natriuretic peptide concentration in essential hypertension

作　　者：蒋作锋[1] 韦建瑞[1] 余慧文[1] 郭顺华[1] 张锐[1] 张文超[1] 陈辉[1] 黄丽萍[1] 郭衡山 

机构地区：[1]广州市红十字会医院暨南大学医学院第四附属医院心内科,广州510220

出　　处：《岭南心血管病杂志》2005年第6期383-385,共3页South China Journal of Cardiovascular Diseases

基　　金：广州市医药卫生科技项目(编号:2003012)

摘　　要：目的研究原发性高血压患者N端脑钠肽前体(N-terminalpro-brainnatriureticpeptide,NT-proBNP)水平及其与左心室扩大和心功能的关系。方法测定原发性高血压患者64例血清NT-proBNP浓度,用心脏彩色多普勒检查测定其左心室舒张末径、左心室射血分数及二尖瓣血流E峰速度与A峰速度的比值(E/A)。结果血浆NT-proBNP浓度在左心室扩大组为(0.33±0.23)μg/L,显著高于左心室正常组(0.12±0.07)μg/L,差异有统计学意义(P<0.01);在重度高血压组为(0.25±0.19)μg/L,较轻中度高血压组(0.14±0.14)μg/L增高,差异有统计学意义(P<0.05);伴有舒张功能不全的高血压患者其血清NT-proBNP浓度和舒张功能正常者相比也有升高的趋势,但差异无统计学意义。血清NT-proBNP浓度与年龄(r=0.40,P<0.01)和左心室舒张末径(r=0.55,P<0.01)呈正相关,与射血分数呈负相关(r=-0.37,P<0.01)。结论NT-proBNP可以作为高血压患者左心室扩大及收缩功能下降的指标,其与舒张功能的关系值得进一步的研究。Objectives To study the relationship between N terminal pro-brain natriuretic peptide （NT-proBNP） and left ventricular dysfunction in essential hypertension. Methods To determine serum NT-proBNP concentration and perform echocardiography to acquire left ventricular end-diastolic diameter（LVEDD）, left ventricular ejection fraction （EF） and E/A ratio. Results Serum NT-proBNP concentration was higher in the patients with enlarged LVEDD and severe hypertension than in the patients with normal LVEDD and mild-moderate hypertension, （0.33±0.23）μg/L vs （0. 12±0.07）μg/L,P〈0.01 and （0.25±0.19）μg/L vs （0.14±0.14）μg/L, P〈0.05）. Serum NT-proBNP concentration was also higher in the patients with E/A〈1,but P 〉0.05. NTproBNP was positively related to age and LVEDD （r=0.40,P〈0.01 and r=0.55 ,P〈0.01）,negatively related to EF（r=-0.37,P〈0.01）. Conclusions NT-proBNP could indicate the enlargement and systolic dysfunction of left ventricle. The relationship between NT-proBNP and diastolic dysfunction of left ventricle needs more evidences.

关 键 词：原发性高血压 N端脑钠肽前体 左心室舒张功能 测定 左心室扩大 

分 类 号：R544.1[医药卫生—心血管疾病]