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目的探讨血浆corin与原发性高血压患者心房钠尿肽(ANP)、脑钠尿肽水平及左心室肥厚的相关性,以及培哚普利干预疗效。方法入选原发性高血压患者68例[左心室肥厚(LVH)组28例,无左心室肥厚(NLVH)组40例],均予以培哚普利治疗8周,以30名健康体检者作为对照组。用酶联免疫吸附试验(ELISA)法测定血浆corin、ANP和脑钠尿肽水平,超声心动图测量舒张期室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室舒张末期内径(LVEDD),并计算左心室质量指数(LVMI)。结果治疗前NLVH组、LVH组和对照组的血浆corin、ANP和脑钠尿肽浓度比较差异有统计学意义,且LVH组corin、ANP和脑钠尿肽明显高于NLVH组[(1950.3±401.9)比(1238.6±379.7)ng/L;(63.2±16.0)比(49.5±15.8)ng/L;(77.1±19.2)比(55.0±20.5)ng/L;均P<0.05]。Corin水平与LVMI、ANP和脑钠尿肽水平呈正相关(r=0.616,r=0.574,r=0.605,均P<0.01)。多元线性逐步回归分析显示,与LVMI独立相关的指标是corin和脑钠尿肽(β=0.504和0.171,均P<0.01);培哚普利治疗8周后,原发性高血压患者的corin、ANP及脑钠尿肽水平较治疗前降低[NLVH组:(1111.3±293.9)比(1238.6±379.7),(44.5±11.6)比(49.5±15.8),(47.2±14.2)比(55.0±20.5)ng/L,均P<0.05;LVH组:(1666.7±398.8)比(1950.3±401.9),(48.7±9.1)比(63.2±12.0),(48.3±10.5)比(77.1±19.2)ng/L,均P<0.01]。结论高血压患者血浆corin与ANP、脑钠尿肽水平呈正相关。血浆corin与高血压LVH呈正相关。培哚普利降压的同时可降低血浆corin水平。
Objective To investigate the relationship between plasma corin and atrial natriuretic peptide (ANP), brain natriuretic peptide and left ventricular hypertrophy in patients with essential hypertension and the therapeutic effect of perindopril intervention. Methods Sixty-eight patients with left ventricular hypertrophy (LVH) and 40 patients without left ventricular hypertrophy (NLVH) were enrolled in this study. All of them were treated with perindopril for 8 weeks. Thirty healthy subjects were included as Control group. Plasma levels of corin, ANP and brain natriuretic peptide were measured by enzyme linked immunosorbent assay (ELISA). Echocardiography was used to measure the interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular end diastolic diameter LVEDD), and calculate left ventricular mass index (LVMI). Results The plasma levels of corin, ANP and brain natriuretic peptide in NLVH group, LVH group and control group before treatment were significantly different, and the levels of corin, ANP and BNP in LVH group were significantly higher than those in NLVH group [(1950.3 ± 401.9 (1238.6 ± 379.7) ng / L; (63.2 ± 16.0) vs (49.5 ± 15.8) ng / L; (77.1 ± 19.2) vs (55.0 ± 20.5) ng / L, all P <0.05]. Corin levels were positively correlated with LVMI, ANP and brain natriuretic peptide (r = 0.616, r = 0.574, r = 0.605, all P <0.01). Multivariate linear stepwise regression analysis showed that coron and brain natriuretic peptide (β = 0.504 and 0.171, both P <0.01) were independently associated with LVMI. After 8 weeks of perindopril treatment, corin , ANP and brain natriuretic peptide were significantly lower than those before treatment [NLVH group: (1111.3 ± 293.9) vs (1238.6 ± 379.7), (44.5 ± 11.6) vs (49.5 ± 15.8), (47.2 ± 14.2) vs (55.0 ± 20.5 (P <0.05); LVH group: (1666.7 ± 398.8) vs (1950.3 ± 401.9), (48.7 ± 9.1) vs (63.2 ± 12.0), (48.3 ± 10.5) vs (77.1 ± 19.2) ng / L, both P <0.01]. Conclusions There is a positive correlation between plasma corin and ANP and brain natriuretic peptide in hypertensive patients. Plasma corin and LVH were positively correlated. Perindopril reduces blood pressure and coron levels at the same time.