缬沙坦对原发性高血压伴左心室肥厚及血浆N—proBNP水平的影响  

The Relationship between Plasma N-terminal Pro-Brain Natriuretic Peptide and Left Ventricular Hypertrophy in Essential Hypertension

作　　者：潘轶斌[1] 包丽芳[1] 陈杭[1] 徐忠星[1] 杜永远[1] 袁青[1] 

机构地区：[1]浙江省金华市中心医院心内科,321001

出　　处：《心电学杂志》2010年第2期114-116,共3页Journal of Electrocardiology(China)

摘　　要：目的观察原发性高血压伴左心室肥厚患者的血浆N—proBNP水平及缬沙坦治疗前后的影响。方法选取原发性高血压伴左心室肥厚患者（观察组），原发性高血压无左心室肥厚患者（疾病对照组）及血压正常者（正常对照组）各40例，用缬沙坦80一160mg／d治疗24周。分别采用彩色超声多普勒和电化学发光法检测治疗前后左心室质量指数（LVMI），左心室射血分数（LVEF）和血浆N—proBNP浓度。结果（1）治疗前血浆N—proBNP水平观察组较疾病对照组及正常对照组明显升高（P〈0．05）。（2）血浆N—proBNP与左心室质量指数呈显著正相关（r=069，P〈005），与E／A比值呈显著负相关（r=-034，P〈001）。（3）治疗后观察组左心室质量指数较治疗前明显减小（P〈0．05）；治疗后观察组血浆N—proBNP水平较治疗前明显降低（P〈0．05）。而对照组的改变无统计学意义。结论血浆N—proBNP是预测原发性高血压发生左心室重构的良好指标。缬沙坦能够降低血浆N—proBNP浓度，可有效逆转原发性高血压性左心室重构。Objective To investigate the changes of plasma N-terminal pro-brain natriuretic peptide （N-proBNP） and the effect of Valsartan on it in essential hypertension. Methods Hypertensive patients with （40 cases） and without （40 cases ） left ventricular hypertrophy （ LVH ） were treated with Valsartan 80-160 mg daily for 6 months. Left ventricular mass index （LVMI）, left ventricular ejection fraction and plasma N-proBNP were measured before and after treatment. Results （1） Plasma N-proBNP level was significantly higher in Hypertensive patients with than without LVH and control group at baseline （all P 〈 0.05）. （2） Plasma N-proBNP was positively correlated with LVMI （r=O,69,P 〈 0.05） and negatively with E/A （r=-0.34,P 〈 0.05）. （3） LVMI and plasma N-proBNP decreased significantly in patients with LVH （all P 〈 0.05） after treatment. Conclusion Plasma N-proBNP is a good predictor of left ventricular remodeling in patients with hypertension. Treatment with Valsartan can decrease plasma N-proBNP and reverse LVH.

关 键 词：缬沙坦 高血压 左心室肥厚 B型利钠肽 

分 类 号：R544.1[医药卫生—心血管疾病]