高血压患者运动后脑钠肽水平与左心室舒张功能的关系  

Relation of the post-exercise natriuretic peptide level to left ventricular diastolic dysfunction in hypertensive patients

作　　者：林梓卿[1] 吴同果[1] 蒋作锋[1] 张锐[1] 黄丽萍[1] 

机构地区：[1]广州市红十字会医院暨南大学附属第四医院心内科,510220

出　　处：《中国心血管杂志》2008年第5期331-333,共3页Chinese Journal of Cardiovascular Medicine

基　　金：广州市卫生局2006年立项资助项目(编号:2006-YB-212)

摘　　要：目的探讨左室射血分数(LVEF)正常的高血压患者运动后N末端脑钠肽(NT-proBNP)水平的变化程度与左心室舒张功能障碍的相关性。方法试验组共50例高血压患者,左室射血分数≥50%;对照组为30名健康人。均测定静息状态下和运动平板试验后1 min时血清NT-proBNP水平,计算两者之间差值(ΔNT-proBNP)。两组均在静息状态下行经胸壁心脏超声检查。结果静息状态下两组间NT-proBNP水平差异无统计学意义;试验组中二尖瓣舒张早期最大血流速度(E)/心房收缩期最大血流速度(A)(E/A)<1亚组的患者与E/A≥1亚组比较,NT-proBNP水平差异无统计学意义。活动后对照组NT-proBNP水平虽有升高,但差异无统计学意义;试验组NT-proBNP水平差异有统计学意义(NT-proBNP 75.8 ng/L比45.2 ng/L,P<0.05)。试验组与对照组之间ΔNT-proBNP水平差异有统计学意义(ΔNT-proBNP 20.6 ng/L比11.1 ng/L,P<0.05)。试验组E/A<1亚组与E/A≥1亚组及对照组比较,ΔNT-proBNP差异有统计学意义(P<0.01)。结论LVEF正常的高血压患者其静息状态下NT-proBNP水平同健康人,活动后升高,尤其在E/A<1亚组中更加明显。Objective To investigate the relation of the post-exercise N-terminal pro brain natriuretic peptide （NT-proBNP） level to left ventricular diastolic dysfunction in hypertensive patients. Methods A total of 50 hypertensive patients with normal left ventricular systolic function and 30 healthy volunteers were enrolled. Echocardiography was performed in rest and E/A value was measured. Blood was drawn before and after maximal treadmill exercise and NT- proBNP levels were analyzed. Results Baseline NT-proBNP levels were not significantly different between hypertensive group and healthy control group. There was no difference in baseline NT-proBNP levels between the abnormal E/A and normal E/A subgroups in hypertensive group. In control group, there was no difference of NT-proBNP levels before and after exercise; while in the hypertensive group, NT-proBNP level was significantly increased after exercise compared to baseline level （75.8 ng/L vs. 45.2 ng/L, P 〈0. 05）. The increase of NT-proBNP level post exercise （ ANT-proBNP level） in hypertensive group was significantly higher than that in control group （20. 6 ng/L vs. 11.1 ng/L, P 〈0. 05）. In hypertensive group, NT-proBNP level was significantly higher in the abnormal E/A subgroup than in the normal E/A subgroup （42. 7 ng/L vs. 17. 6 ng/L, P 〈 0. 01 ）. Conclusion The NT-proBNP level significantly increases after exercise in hypertensive patients with abnormal E/A. NT-proBNP during exercise is a sensitive index for left ventricular diastolic dysfunction in patients with hypertension.

关 键 词：高血压 利钠肽 脑 运动试验 

分 类 号：R544.1[医药卫生—心血管疾病]