BNP及PCⅢ对不同左心室舒张充盈状态原发性高血压患者的影响分析  

The effect of BNP and PCⅢ on different left ventricular diastolic filling patterns in patients with essential hypertension

作　　者：林文辉[1] 邵健智[1] 彭万军[1] 王齐增[1] 朱玲军[1] 林斌[1] 马湘俊[1] 李新祥[2] 周仁芳[3] 

机构地区：[1]温州医学院附属温岭医院心内科,浙江温岭317500 [2]温州医学院附属温岭医院超声科,浙江温岭317500 [3]温州医学院附属温岭医院检验科,浙江温岭317500

出　　处：《岭南心血管病杂志》2009年第1期17-20,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的分析血浆B型0脑钠肽(natriuretic peptide,BNP)及血清前Ⅲ型胶原(procollagen type Ⅲ,PCⅢ)对不同左心室舒张充盈类型的原发性高血压(高血压)患者的影响。方法入选高血压患者150例,均无收缩功能障碍,根据左心室舒张充盈类型不同分为正常舒张充盈型组、松驰受损型组、假正常充盈型组、限制性充盈型组,所有患者均行多普勒超声心动图检查,用干式快速免疫荧光法定量测定血浆B型BNP浓度,用放射免疫法测定血清PCⅢ浓度。结果①正常舒张充盈型组、松弛受损型组、假正常充盈型组、限制性充盈型组的B型BNP分别为(47±16)pg/mL、(147±24)pg/mL、(206±51)pg/mL、(357±64)pg/ml;正常舒张充盈型组、松弛受损型组、假正常充盈型组、限制性充盈型组PCⅢ分别为(81.5±31.4)μg/L、(107.8±30.8)μg/L、(125.3±37.3)μg/L、(157.4±55.4)μg/L,以限制性充盈型组增高最显著,方差分析显示B型BNP与PCⅢ在高血压患者4组间的差异有统计学意义(F=406.6,P<0.05;F=25.4,P<0.05)。②血浆B型BNP与血清PCⅢ呈正相关(r=0.580,P<0.05)。结论血浆B型BNP及血清PCⅢ可客观反映无收缩功能障碍的高血压患者左心室舒张功能受损程度。Objectives To investigate the relationship between different left ventricular diastolic filling patterns and the level of plasma B-type natriuretic peptide （BNP） and serum procollagen type Ⅲ （PCⅢ ） in essential hypertensive patients. Methods One hundred and sixty essential hypertensive patients were enrolled in this study. The essential hypertensive patients referred for Doppler-chocardiography to evaluate left ventricular function, while patients with abnormal systolic function were excluded, and then patients were classified as normal, impaired relaxation, pseudonormal, and restrietivelike filling patterns. Serum proeollagen type m （ PCⅢ ） was measured by radioimmunoassay, and while plasma B-type BNP level was measured by a point-of-care immunoassy. Results The levels of plasma B-type BNP and serum PC Ⅲ in three abnormal left ventricular diastolic function groups were all higher than those in normal left ventricular function group [ （147±24） pg/mL, （206±51） pg/mL, （357±64） pg/mL vs （47±16） pg/mL, （107.8±30.8） μg/L, （125.3±37.3） μg/L; （157.4±55.4） μg/L vs （81.5±31.4） μg/L, P〈0.05 ）]. Patients with restrictivelike filling patterns on Doppler-echocardiography had the highest B-type BNP and PCⅢ levels （P〈0.05）. There were significant positively relationship between the level of Plasma B-type BNP and serum PC Ⅲ（ r=0.58, P〈0.05 ）. Conclusions The levels of plasma B-type BNP and serum PC Ⅲ are reliable objective marker to reflect the extent of left ventricular diastolic dysfunction.

关 键 词：高血压 左心室 舒张 利钠肽 前Ⅲ型胶原 

分 类 号：R542.2[医药卫生—心血管疾病]