老年原发性醛固酮增多症和高血压患者N末端B型钠尿肽前体及心脏早期损害的研究  

NT-proBNP level and early cardiac damage in elderly patients with primary aldosteronism and essential hypertension

作　　者：张宝丽[1] 许建忠[1] 何瑞青[1] 杜雅楠[1] 杨 唐晓峰[1] 高平进[1] ZHANG Bao-li XU Jian-zhong HE Rui-qing et al(Department of Hypertension ,Affiliated Ruijin Hospital of Shanghai Jiaotong University Medical School, Shanghai 200025 ,Chin)

机构地区：[1]上海交通大学医学院附属瑞金医院高血压科上海市高血压研究所,200025

出　　处：《中华老年心脑血管病杂志》2017年第3期241-244,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：上海市卫计委重点基金项目(201440023)

摘　　要：目的分析老年原发性醛固酮增多症(PA)和原发性高血压(EH)患者N末端B型钠尿肽前体(NT-proBNP)水平对老年患者早期心脏损害的评价价值。方法连续选择2009年12月~2014年6月在我院接受治疗的149例高血压患者,其中确诊为PA的70例患者为病例组,排除PA并确诊为EH的79例患者为对照组。观察并比较2组患者早期心脏损害指标NT-proBNP和左心室质量指数(LVMI)。结果病例组log NT-proBNP(1.9±0.4 vs1.7±0.5,P=0.001)、LVMI[(116.5±20.8)g/m2 vs(106.3±21.7)g/m2,P=0.004]和左心室肥厚(67.1%vs50.6%,P=0.041)比例明显高于对照组。多元线性逐步回归分析显示,病例组LVMI及激活醛固酮水平与NT-proBNP独立相关,对照组诊室收缩压水平与NT-proBNP独立相关。结论老年PA患者较EH患者有独立于血压水平的更高的log NT-proBNP水平及更早的心脏损害。Objective To analyze th role of NT-proBNP in assessing the early cardiac damage in elderly patients with primary aldosteronism（PA）and essential hypertension（EH）.MethodsOne hundred and forty-nine hypertensive patients admitted to our hospital from December 2009 to June 2014 were divided into PA group（n=70）and control group（n=79）.Their serum NT-proBNP level and LVMI were measured.Results The log NT-proBNP level,LVMI and the incidence of left ventricular hypertrophy were significantly higher in PA group than in control group（1.9±0.4 vs 1.7±0.5,P=0.001;116.5±20.8 vs 106.3±21.7g/m^2,P=0.004;67.1%vs 50.6%,P=0.041）.Multivariate linear regression analysis showed that LVMI and serum aldosterone level were independently related with log NT-proBNP level in PA group and office systolic blood pressure was independently related with log NT-proBNP level in control group.Conclusion The serum NT-proBNP level is higher and the cardiac damage is earlier in elderly PA patients than in EH patients independent of their blood pressure.

关 键 词：醛固酮增多症 高血压 利钠肽 脑 肥大 左心室 

分 类 号：R586.24[医药卫生—内分泌]