血浆脑钠素浓度与老年高血压患者左室肥厚及心功能的关系  

Plasma Brain Natriuretic Peptide Concentration and Left Ventricular Hypertrophy in elderly Hyperension

作　　者：余惠珍[1] 朱鹏立[1] 沈晓丽[2] 李峰[1] 卢荔红[3] 江芸[1] 

机构地区：[1]福建省立医院二内科,福建省临床老年病研究所 [2]福建省心血管病重点实验室 [3]福建省心血管病研究所心内科,福建福州350001

出　　处：《高血压杂志》2006年第5期356-359,共4页Chinese Journal of Hypertension

基　　金：福建省卫生厅青年科研基金资助项目(2338)

摘　　要：目的 观察老年高血压患者左室肥厚与血浆脑钠素（BNP）浓度的关系，并以贝那普利治疗前后左室肥厚及左室舒张功能不全的变化情况，探讨血浆BNP浓度可否作为判断左心室肥厚的逆转及左室舒张功能改变的临床指标。方法老年高血压患者74例，平均年龄（72．0±11．6）岁，其中伴左心室肥厚组患者34例、不伴左心室肥厚组患者40例，正常对照组30例，予以高血压病患者贝那普利5～10mg／d治疗36周，所有对象行超声心动图测定左心室质量指数（LVMI），E／A比值；采用美国博适Triage及其试剂盒快速测定血浆BNP水平，对BNP与LVMI、E／A比值作相关分析。结果老年高血压左心室肥厚患者组的血浆BNP水平明显高于高血压病不伴左心室肥厚患者组和正常对照组（P〈0．01），经贝那普利治疗后高血压病左心室肥厚患者组血浆BNP水平明显下降（P〈0．05），且与LVMI呈显著正相关，与E／A比值呈显著负相关。结论血浆BNP浓度能较好地反映老年高血压患者左心室肥厚及左室舒张功能状态。Objective To study the relationship between brain natriuretic peptide（BNP）and left ventricular hypertrophy（LVH） in elderly essential heypertensives（EH） and the level of BNP before and after treatment with ACEI. Methods Echocardiography was performed to determine left ventricular mass index（ LVMl）and E/A ratio. Plasma BNP was measured by RIA in 74 aged hypertensives（mean ages 72.0±11.6 years） with 30 healthy subjects （mean age 69.0±9.6 years） served as control. The elder hypertensives with LVH were treated with benazepril 5-10 mg/d for 36 weeks. Results Plasma BNP was significantly increased （P〈0.01） in elderly hypertensives with LVH as compared with those without LVH and with health subjects （55.3±25.0 ng/L vs without LVH 38.3±17.9 ng/L, vs healthy 15.2±12.8 ng/L, P〈0.01）. Benazepril treatment significantly decreased plasma BNP and LVMI with LVH （P〈 0. 05）, increased in the E/A ratio in EH with LVH（P〈0.01）, The plasma BNP positively was correlate with LVMI and negatively with E/A ratio, Conclusion Plasma BNP reflect the left ventricular hypertrophy and cardiodiastolic function in elderly hypertensives.

关 键 词：老年高血压 左心室肥厚 脑钠素 

分 类 号：R541.3[医药卫生—心血管疾病]