原发性高血压合并舒张性心力衰竭左房容积指数与血清脑钠肽相关性研究  

Correlation Between Left Atrial Volume Index and Serum Brain Natriuretic Peptide in Patients with Essential Hypertension Complicated with Diastolic Heart Failure

作　　者：杨萌萌 王淑珍 赵若寒 熊峰 YANG Mengmeng;WANG Shuzhen;ZHAO Ruohan;XIONG Feng(Department of Cardiology,The Third People s Hospital of Chengdu,Chengdu Institute of Cardiovascular Diseases,The Affiliated Hospital of Southwest Jiaotong University,Chengdu 610031,Sichuan,China)

机构地区：[1]西南交通大学附属医院成都市第三人民医院心内科成都市心血管病研究所,四川成都610031

出　　处：《心血管病学进展》2021年第7期667-672,共6页Advances in Cardiovascular Diseases

基　　金：四川省卫生和计划生育委员会科研课题(17PJ385)。

摘　　要：目的探讨原发性高血压(EH)合并舒张性心力衰竭(DHF)患者左房容积指数(LAVI)与血清脑钠肽(BNP)水平的相关性。方法选择EH合并DHF患者65例,EH不伴DHF患者77例,根据年龄及性别匹配健康对照组70例。超声心动图测量二尖瓣舒张早期血流速度峰值(E峰)及舒张晚期血流速度峰值(A峰),并计算E/A。组织多普勒测量二尖瓣环间隔侧的舒张早期二尖瓣环峰值(e’峰),Simpson's法测量并计算LAVI;同时检测BNP和肾功能等生化指标。对三组患者E/e’、e’峰、LAVI和BNP对数转换(lgBNP)水平进行比较,并完成lgBNP和LAVI的相关性分析。结果(1)EH合并DHF组LAVI、E/e'[(35.42±1.99)mL/m2、16.22±3.23]高于EH不伴DHF组[(31.89±1.75)mL/m2、11.02±2.13]及健康对照组[(23.52±1.32)mL/m2、7.11±0.20],差异有统计学意义(P<0.05);(2)EH合并DHF组lgBNP(2.55±0.12)明显高于其他两组(1.40±0.15、1.35±0.18),差异有统计学意义(P<0.05);(3)lgBNP、LAVI与E/e'呈正相关(r=0.893,P<0.01;r=0.730,P<0.01);与e'呈负相关(r=-0.788,P<0.01);(4)LAVI诊断DHF的ROC曲线下面积为0.961,根据ROC曲线,当LAVI取值为32.5 mL/m2时灵敏度和特异度之和最大,超过此值可考虑存在DHF。结论EH合并DHF患者LAVI与BNP明显高于不伴DHF者,LAVI联合BNP有助于识别EH合并DHF。Objective To investigate the correlation between left atrial volume index(LAVI)and serum brain natriuretic peptide(BNP)level in patients with essential hypertension(EH)complicated with diastolic heart failure(DHF).Methods 65 EH patients with DHF and 77 EH patients without DHF were selected,and 70 healthy controls were matched according to age and sex.The early diastolic blood flow velocity(peak E)and late diastolic blood flow velocity(peak A)of the mitral valve were measured and E/A was calculated.Tissue Doppler was used to measure e'peak on the septal side of the mitral annulus.The Simpson method measured and calculated LAVI,and biochemical indexes such as BNP and renal function were detected at the same time.The E/e',e',LAVI and lgBNP levels of the three groups were compared,and the correlation analysis between lgBNP and LAVI was completed.Results(1)LAVI,E/e'[(35.42±1.99)mL/m2,16.22±3.23]in group of EH with DHF was higher than that in the group of EH without DHF[(31.89±1.75)mL/m2,11.02±2.13]and group of healthy[(23.52±1.32)mL/m2,7.11±0.20],the difference was statistically significant(P<0.05);(2)lgBNP(2.55±0.12)in the EH with DHF group was significantly higher than that in the other two groups(1.40±0.15,1.35±0.18),and the difference was statistically significant(P<0.05);(3)lgBNP and LAVI were positively correlated with E/e'(r=0.893,P<0.01;r=0.730,P<0.01),and negatively correlated with e'(r=-0.788,P<0.01);(4)The area under the ROC curve of LAVI in diagnosing DHF was 0.961.According to the ROC curve,when the value of LAVI was 32.5 mL/m2,the sum of sensitivity and specificity reached the maximum,and the existence of DHF could be considered if the value exceeded this value.Conclusion LAVI and BNP in EH patients with DHF were significantly higher than those without DHF.LAVI combined with BNP was helpful to identify EH patients with DHF.

关 键 词：左房容积指数 血清脑钠肽 原发性高血压 舒张性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]