肾实质性高血压和原发性高血压对心功能影响的临床研究  

Clinical study on the effect of Renal parenchymal hypertension and primary hypertension on cardiac function

作　　者：弓旭东 张冰[1] 张玉良[1] 刘芳萍[1] 周凯骏 GONG Xudong;ZHANG Bing;ZHANG Yuliang(Department of Cardiology, Haiyan People’s Hospital, Jiaxing 314300, China)

机构地区：[1]浙江省海盐县人民医院心内科,314300

出　　处：《心电与循环》2016年第6期425-427,434,共4页Journal of Electrocardiology and Circulation

基　　金：海盐县卫计委科技计划一般项目(2014wsyb004)

摘　　要：目的比较肾实质性高血压和原发性高血压患者的心功能的不同。方法选择肾实质性高血压患者(肾实质性高血压组)和原发性高血压患者(原发性高血压组)各66例,测量两组患者身高、体重、N末端脑钠肽前体(NT-pro BNP)、左心室射血分数(LVEF)、左心室舒张末期内径(LVIDd)、左心室收缩末期内径(LVIDs),继而得出左心室质量(LVM)、体表面积及左心室质量指数(LVMI)。分析比较各组NT-pro BNP水平与左心室结构参数的差异。结果肾实质性高血压组患者LVMI、LVIDd、LVIDs、NT-p ro BNP[(126.7±29.6)g/m^2、(49.9±3.8)mm、(32.2±4.1)mm、2 150.0ng/L]均高于原发性高血压组[(96.1±10.0g)/m^2、(41.6±4.7)mm、(28.0±2.0)mm、162.5ng/L],LVEF[(64.3±6.5)%]低于原发性高血压组[(67.6±6.1)%]。差异均有统计学意义(均P<0.05)。结论肾实质性高血压组对左心室肥厚及心功能不全的影响程度较原发性高血压组更明显。Objective Comparison of cardiac function in patients with renal parenchymal hypertension and essentialhypertension. Methods Selection of patients with renal parenchymal hypertension 66 cases (renal hypertension group)and 66 cases of patients with primary hypertension (hypertension group), the measurement of plasma brain natriureticpeptide in patients with precursor(NT-proBNP), left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVIDd), left ventricular the systolic diameter (LVIDs), calculate the left ventricular mass index (LVMI). The differences ofNT-proBNP levels and left ventricular structure parameters were analyzed and compared between the groups. ResultsRenal hypertension group, left ventricular mass index (LVMI)、left ventricular end diastolic diameter (LVIDd)、left ventricularsystolic diameter(LVIDs) and plasma NT-proBNP [(126.7±29.6)g/m2、(49.9±3.8)mm、(32.2±4.1)mm、2 150ng/L] were higherthan those in primary hypertension group [(96.1±10.0)g/m2、(41.6±4.7)mm、(28.0±2.0)mm、162.5ng/L], left ventricularejection fraction (LVEF)[(64.3±6.5)%] was lower than that of primary hypertension group [(67.6±6.1)%]. The difference wasstatistically significant (P<0.05). Conclusion The effect of renal parenchymal hypertension on left ventricular hypertrophyand cardiac insufficiency was more significant than that in primary hypertension group .

关 键 词：肾实质性高血压 原发性高血压 血浆脑钠肽前体(NT-proBNP) 左心室结构 左心功能不全 

分 类 号：R544.1[医药卫生—心血管疾病]