高血压患者血清Lp-PLA2、sCD40L及NT-proBNP水平与左心室肥厚的关系  

Relationship between levels of serum Lp-PLA2,sCD40L and NT-proBNP and left ventricular hypertrophy in patients with hypertension

作　　者：刘颖 何流 龙佩 刘春艳 朱薇 LIU Ying;HE Liu;LONG Pei;LIU Chunyan;ZHU Wei(Department of Laboratory Medicine,West China Guang′an Hospital,Sichuan University,Guang′an 638500,Sichuan,China)

机构地区：[1]四川大学华西广安医院检验科,四川广安638500

出　　处：《西部医学》2022年第6期918-922,共5页Medical Journal of West China

摘　　要：目的探讨高血压患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、可溶性CD40配体(sCD40L)及N端脑钠肽前体(NT-proBNP)水平与左心室肥厚(LVH)的关系。方法回顾性分析2018年3月~2020年1月我院102例原发性高血压合并LVH患者(LVH组)及96例原发性高血压无LVH患者(非LVH组)的临床资料,比较两组基线资料及血清Lp-PLA2、sCD40L、NT-proBNP水平差异,评估血清Lp-PLA2、sCD40L水平与NT-proBNP及超声心动图参数的相关性,使用受试者工作特征曲线(ROC曲线)评估血清Lp-PLA2、sCD40L、NT-proBNP及其联合检测对原发性高血压合并LVH的诊断价值。结果两组性别、年龄、高血压家族史、酗酒史、吸烟史、基础血压、左室射血分数比较,差异均无统计学意义(P>0.05),LVH组高血压病程、左心室质量指数(LVMI)等超声心动图参数及钙离子通道阻断剂使用率均高于非LVH组(P<0.05),两组其他用药情况比较,差异均无统计学意义(P>0.05)。LVH组血清Lp-PLA2、sCD40L、NT-proBNP水平均显著高于非LVH组(P<0.05)。经Pearson相关性分析,发现原发性高血压患者血清Lp-PLA2、sCD40L水平与NT-proBNP及LVEDD、LVESD、LVEDV、LVESV、LVMI均呈显著正相关(P<0.05)。经ROC曲线分析,发现血清Lp-PLA2、sCD40L、NT-proBNP均对原发性高血压合并LVH具有较高诊断价值(P<0.05),其截断值分别为405.92 ng/mL、2.94μg/L、214.92 ng/L,且3项联合诊断价值最高,AUC可高达0.988。结论血清Lp-PLA2、sCD40L水平与左心室形态学改变密切相关,与心室重构指标NT-proBNP联合检测能辅助临床诊断原发性高血压合并LVH,对诊疗具有指导意义。Objective To analyze the relationship between levels of serum lipoprotein-associated phospholipase A2(Lp-PLA2),soluble CD40 ligand(sCD40L)and N-terminal pro-brain natriuretic peptide(NT-proBNP)and left ventricular hypertrophy(LVH)in patients with hypertension.Methods The clinical data of 102 patients with essential hypertension complicated with LVH(LVH group)and 96 patients with essential hypertension without LVH(non-LVH group)were retrospectively analyzed.The baseline data and levels of serum Lp-PLA2,sCD40L and NT-proBNP were compared between the two groups,and the correlation between levels of serum Lp-PLA2 and sCD40L and NT-proBNP and echocardiographic parameters was evaluated.Receiver operating characteristic curve(ROC curve)was used to evaluate the diagnostic value of serum Lp-PLA2,sCD40L,NT-proBNP and their combined detection on essential hypertension with LVH.Results There were no significant differences in gender,age,family history of hypertension,history of alcoholism,smoking history,basal blood pressure and left ventricular ejection fraction between the two groups(P>0.05).The echocardiographic parameters of duration of hypertension and left ventricular mass index(LVMI)and utilization rate of calcium channel blockers in LVH group were higher than those in non-LVH group(P<0.05),and there were no statistically significant differences in other medications between the two groups(P>0.05).The levels of serum Lp-PLA2,sCD40L and NT-proBNP in LVH group were significantly higher than those in non-LVH group(P<0.05).Pearson correlation analysis showed that the levels of serum Lp-PLA2 and sCD40L in patients with essential hypertension were significantly positively correlated with NT-proBNP,LVMI and other echocardiographic parameters(P<0.05).After ROC curve analysis,it was found that serum Lp-PLA2,sCD40L and NT-proBNP had high diagnostic value on essential hypertension with LVH(P<0.05),and their cut-off values were 405.92 ng/mL,2.94μg/L and 214.92 ng/L respectively,and the combination of the three had the highest dia

关 键 词：原发性高血压 左心室肥厚 脂蛋白相关磷脂酶 可溶性CD40配体 N端脑钠肽前体 心室重构 

分 类 号：R544.1[医药卫生—心血管疾病]