血浆脑钠肽及Tei指数与高血压患者不同左心室构型相关关系的研究  

Relationships among plasma brain natriuretic peptide level and Tei index and different left ventricular geometric patterns in patients with essential hypertension

作　　者：高枫[1] 苏伟[1] 龚少愚[1] 陆曙[1] 张亦哲[2] 刘志华[3] 

机构地区：[1]无锡市中医院心内科,江苏无锡214037 [2]无锡市中医院超声科,江苏无锡214037 [3]苏州大学附属第一医院心内科,江苏苏州215006

出　　处：《临床荟萃》2009年第9期743-745,共3页Clinical Focus

摘　　要：目的探讨脑钠肽(BNP)与Tei指数与原发性高血压(EH)患者不同左心室构型的关系。方法选择132例EH患者及34例正常对照者行经胸超声心动图检查,测量室间隔厚度、左心室后壁厚度、左心室舒张末期内径、左心室射血分数及左心房内径、等容收缩期、射血时间和等容舒张期,计算左心室质量指数(LVMI)、左心室室壁相对厚度(LVRWT)及左心室Tei值。同时采用酶联免疫吸附(ELISA)法测定其血浆中BNP浓度。依据超声心动图测值计算的LVMI、LVRWT结果将132例EH患者分为4个亚组:正常构型组(A组31例)、向心性重构组(B组37例)、向心性肥厚组(C组33例)、离心性肥厚组(D组31例)。结果①BNP水平D组显著高于A组、B组、C组及对照组,5.41±1.13 vs 3.31±1.22、3.85±1.47、4.48±1.18、2.96±1.03(P<0.01);②Tei值B组、C组、D组显著高于对照组,0.43±0.07、0.46±0.11、0.57±0.13 vs 0.34±0.07(P<0.01);③BNP水平、Tei指数与EH的不同左心室构型有密切相关性(r=0.420,0.480,均P<0.01);BNP水平与Tei指数密切相关(r=0.360,P<0.01)。结论BNP及Tei指数与EH患者不同左心室构型密切相关。Objective To explore the clinical value of brain natriuretic peptide （BNP） and Tel index in assessment of left ventricular function in patients with essential hypertension（EH） with different patterns of left ventricular geometric model. Methods 132 hospitalized patients with EH and 34 healthy controls were examined by echocardiography. The parameters including interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end-diastolic dimension, left ventricular ejection fraction, left atrium dimension, isovolumic contraction time, ejection time and isovolumic relaxation time were measured. The left ventricular mass index （LVMI）, left ventricular relative wall thickness（LVRWT） and Tel index were calculated. At the same time, the plasma BNP level was measured by chemilumlnescent immunoassay. According to left ventricular morphology（LVMI, LVRWT）, the patients with EH were further divided into four groups： normal left ventricular （group A, 31cases）, concentric remodeling group （group 13,37 cases）,concentric hypertrophy group （group C, 33 cases）, eccentric hypertrophy group （group D,31 cases）. Results （1） The plasma concentration of BNP in group D was significantly higher than that in group A ,group B,group C and control group,5.41±1.13 vs 3.31±1.22,3.85±1.47,4. 48±1.18,2.96±1.03（ P〈 0.01）; （2） Tei index in group B, group C,group D was significantly higher than that in control group 0.43 ±0.07, 0. 46±0.11,0. 57±0.13 vs 0. 345=0.07（ P 〈0.01） ;（3） There was a close correlation between plasma BNP, Tei index and different left ventricular geometric patterns in EH （ r = 0. 420,0. 480, both P 〈 0.01）. The BNP level was positively correlated with Tel index（ r = 0. 360, P 〈0. 01）. Conclusion There is a positive correlation between plasma BNP level,Tel index and different left ventricular patterns in EH.

关 键 词：高血压 利钠肽 脑 超声心动描记术 

分 类 号：R544.1[医药卫生—心血管疾病]