脑钠肽与高血压左室重塑、左室功能的关系  

Relationship between brain natriuretic peptide and left ventricular remodeling and function in essential hypertension

作　　者：吴波[1] 张书富[1] 陈德[1] 马瑾[1] 周依蒙[1] 华尔铨[1] 

机构地区：[1]上海交通大学附属新华医院分院上海杨浦区中心医院心内科,上海200090

出　　处：《临床心血管病杂志》2007年第7期510-512,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨原发性高血压(EH)患者脑钠肽(BNP)水平与左室几何构型、左室功能的关系。方法:应用荧光免疫法快速测定EH组(106例)和对照组(46例)的血浆BNP浓度,根据心脏彩色超声检测结果,依照左室重量指数(LVMI)、相对室壁厚度(RWT)将106例EH患者分为:正常构型亚组(12例)、向心性重构亚组(9例)、离心性肥厚亚组(64例)、向心性肥厚亚组(21例)。应用相关性分析了解EH组LVMI、RWT、年龄、血压、体质指数(BMI)、左室射血分数(LVEF)等因素与BNP关系。结果:在EH各构型亚组中LVMI以离心性肥厚亚组最高,向心性肥厚亚组、离心性肥厚亚组BNP水平较对照组升高明显。EH组LVMI与BNP具有明显的正相关性(r=0.605,P<0.01),RWT与BNP具有明显的负相关(r=-0.266,P<0.01),LVEF与BNP呈负相关(r=-0.552,P<0.01),LVMI、RWT与血压、BMI之间无明显相关性。结论:EH组中不同的左室几何构型对BNP水平产生不同影响,具有更高的LVMI值和更低的LVEF、RWT值患者,BNP水平更高,而年龄、血压、BMI与BNP、LVMI、RWT无明显相关性。Objective：To investigate the relationship between brain natriuretic peptide（BNP） level and left ventricular geometry and function in the patients of essential hypertension（EH）. Method： The serum BNP concentration of 46 controls and 106 EH patients were measured quickly by luminoimmunoassay. According to left ventricular mass index（LVMI） and relative wall thickness （RWT）, measured by colored Doppler echocardiography, 106 patients of EH were divided into normal geometry group （12 cases） and concentric remodeling group （9 cases）, eccentric hypertrophy group （64 cases）, concentric hypertrophy group（21 cases）. Observe the different of BNP levels in patients of EH with different left ventricular geometry, and anatyze the correlations of BNP levels and LVMI, RWT, ages, blood pressure, body mass index（BMI）, left ventricular ejection fraction （LVEF） were assessed by using correlation analysis. Result：The LVMI values were the highest in eccentric hypertrophy group, BNP levels in eccentric hypertrophy group and concentric hypertrophy group were higher than those in normotensive control subjects, and the differences were significant obviously. There was obviously positive correlation with LVMI and BNP levels in EH （r= 0. 605, P〈0.01） ; negative correlation with RWT and BNP levels（ r= - 0. 266, P〈0.01）; and negative correlation with EF and BNP levels（r=-0. 552, P〈0.01）. There were no significant correlations with LVMI, RWT and blood pressure, BMI. Conclusion：Different left ventricular geometry produced different influences to BNP levels in EH, BNP levels were higher in the patients with higher LVMI values and lower LVEF, RWT values. However, there were no significant correlations with ages, blood pressure, BMI and BNP, LVMI, RWT.

关 键 词：高血压 心室肥厚 左 心室功能 左 B型利钠肽 

分 类 号：R544.1[医药卫生—心血管疾病]