高血压合并心力衰竭患者的BNP、AngⅡ、Apelin水平及与心功能的相关性  

BNP,AngII,Apelin levels and their correlation with cardiac function in hypertensive patients with heart failure

作　　者：宋蕾 张洪磊 袁玉敏 陈健 SONG Lei;ZHANG Hong-lei;YUAN Yu-min;CHEN Jian(Department of Cardiology,Chongming Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai,202150,China)

机构地区：[1]上海健康医学院附属崇明医院心内科,上海202150

出　　处：《心血管康复医学杂志》2025年第2期150-155,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨高血压合并心力衰竭患者的脑利钠肽(BNP)、血管紧张素Ⅱ(AngⅡ)、脂肪细胞因子(Apelin)水平及与心功能的相关性。方法:选择2021年1月-2022年10月上海健康医学院附属崇明医院收治的110例高血压合并心力衰竭患者(观察组)、110例单纯高血压患者(高血压对照组)和同期入院体检的100例健康体检者(健康对照组)作为研究对象。比较各组间的BNP、AngⅡ、Apelin;采用Pearson相关分析上述指标与心功能的相关性,采用受试者工作特征(ROC)曲线分析BNP、AngⅡ、Apelin联合诊断高血压合并心力衰竭的价值。结果:与健康对照组、高血压对照组比较,观察组BNP、AngⅡ、Apelin、左室舒张末期内径(LVEDd)显著增加,左室射血分数(LVEF)显著降低(P均<0.001)。Pearson相关性分析显示,BNP、AngⅡ、Apelin与LVEF呈负相关(r=-0.607、-0.517、-0.549,P均<0.001),与LVEDd呈正相关(r=0.695、0.676、0.677,P均<0.001)。与Ⅱ级、ⅡI级组比较,IV级BNP[(501.42±65.58) pg/ml比(382.59±49.69) pg/ml比(409.58±53.58) pg/ml]、AngⅡ[(3.24±0.84)ng/ml比(0.85±0.24)ng/ml比(1.06±0.41)ng/ml]、Apelin[(6.53±0.71) pg/ml比(3.55±0.29) pg/ml比(4.98±0.56) pg/ml]水平显著升高(P均<0.001)。ROC曲线分析显示,BNP、AngⅡ、Apelin联合诊断高血压合并心力衰竭ⅡI级~IV级的曲线下面积(AUC)为0.943(95%CI 0.882~0.978),显著高于单一指标(Z=2.960、6.099、4.653,P均<0.01)。结论:BNP、AngⅡ、Apelin联合检测对高血压合并心力衰竭具有较好的诊断价值。Objective:To investigate the levels of brain natriuretic peptide(BNP),angiotensin II(AngII)and Apelin in hypertensive patients with heart failure and their correlation with cardiac function.Methods:A total of 110 patients with hypertension and heart failure(observation group),110 hypertensive patients(hypertension control group)and 100 healthy subjects undergoing physical examination simultaneously(healthy control group)admitted to Chongming Hospital Affiliated to Shanghai University of Medicine&Health Sciences between January 2021 and October 2022 were enrolled.BNP,AngII and Apelin levels were compared among above-mentioned groups.Pearson correlation analysis was employed to analyze association of above indexes with cardiac function.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of BNP,AngII and Apelin combination for hypertension combined heart failure.Results:Compared with participants in healthy control group and hypertension control group,those in observation group had significant higher BNP,AngII,Apelin and left ventricular end-diastolic diameter(LVEDd),and significant lower left ventricular ejection fraction(LVEF)(P<0.001 all).Pearson correlation analysis showed that BNP,AngII,Apelin were negatively correlated with LVEF(r=-0.607,-0.517,-0.549,P<0.001 all),while they were positively correlated with LVEDd(r=0.695,0.676,0.677,P<0.001 all).Compared with patients in class II and class III groups,those in class IV group had significant higher BNP[(501.42±65.58)pg/ml vs.(382.59±49.69)pg/ml vs.(409.58±53.58)pg/ml],AngII[(3.24±0.84)ng/ml vs.(0.85±0.24)ng/ml vs.(1.06±0.41)ng/ml],Apelin[(6.53±0.71)pg/ml vs.(3.55±0.29)pg/ml vs.(4.98±0.56)pg/ml](P<0.001 all).ROC curve indicated that the AUC of the combined diagnosis of BNP,AngII and Apelin for hypertensive patients with heart failure of class III~IV was 0.943(95%CI 0.882~0.978),which was significantly higher than that of single index(Z=2.960,6.099,4.653,P<0.01all).Conclusion:BNP,AngII and Apelin combination has good perfor

关 键 词：高血压 心力衰竭 利钠肽 脑 

分 类 号：R541.1[医药卫生—心血管疾病]