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目的:比较原发性高血压患者和健康对照个体血浆脑钠肽水平的差别,研究BNP同左室重量指数的关系,从而探讨BNP与高血压性心室重构的相关性。方法:收集我院2007年-2010年住院及门诊原发性高血压患者86例,以及健康体检者31例,均行血浆BNP,血清hs-CRP,总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),尿素氮(BUN),肌酐(CR),尿酸(UA)测定,同时行彩色多普勒超声心动图检查,记录室间隔厚度(IVST),左室后壁厚度(LVPWT),左室舒张末期内径(LVEDd),左室收缩末期内径(LVEDs),EF值,根据各项超声指标,计算出左室重量及左室重量指数LVMI=LVM/BSA。LVMI=LVM/BSA。所有研究对象分为EH组及健康对照组,86例EH患者按照血压水平的不同分为EH1,EH2,EH3等3组,按照是否合并有LVMI水平增高分为单纯EH组和EH合并LVH组。结果:①EH组较健康对照组BNP水平增高,差别有统计学意义(P=0.019,P<0.05)。②EH1,EH2,EH3组两两比较,EH3组较EH1组,EH2组BNP水平增高(P=0.026,0.029,P<0.05),EH1,EH2组之间差别无统计学意义(P>0.05)。③EH合并LVH组较单纯EH组BNP水平增高(P=0.036,P<0.05)。④随着血浆BNP水平的增高,LVMI增大,二者之间呈正相关关系(r=0.591,P<0.05);BNP与UA,LVEDd呈正相关关系(r=0.355,0.423,P均<0.05)。结论:高血压患者存在BNP水平的增高;BNP可反映高血压心室重构的程度。
OBJECTIVE: To compare the differences of plasma BNP levels in patients with essential hypertension and healthy controls, and to investigate the relationship between BNP and left ventricular mass index (LVMI) and to explore the relationship between BNP and hypertensive ventricular remodeling. Methods: Totally 86 inpatients and outpatients with essential hypertension in our hospital from 2007 to 2010 were enrolled, and 31 healthy subjects were enrolled. Plasma BNP, serum hs-CRP, total cholesterol (TC), triglyceride (TG) ), LDL-C, HDL-C, BUN, CR and UA were detected by color Doppler echocardiography (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVEDs) and EF were measured and recorded. According to each ultrasound index, left ventricular Weight and left ventricular mass index LVMI = LVM / BSA. LVMI = LVM / BSA. All subjects were divided into EH group and healthy control group. 86 patients with EH were divided into three groups: EH1, EH2 and EH3 according to their blood pressure levels. EH and EH were divided into EH group and LVH group according to whether LVMI level increased or not. Results: ① The levels of BNP in the EH group were significantly higher than those in the healthy control group (P = 0.019, P <0.05). ② The levels of BNP in EH3, EH2 and EH2 groups were significantly higher than those in EH1, EH2 and EH3 groups (P = 0.026,0.029, P <0.05). There was no significant difference between EH1 and EH2 groups (P> 0.05). ③ The level of BNP in EH combined with LVH group was higher than that in EH group (P = 0.036, P <0.05). (4) There was a positive correlation between BNP and UA and LVEDd (r = 0.355,0.423, P <0.05) . Conclusion: BNP levels are elevated in patients with hypertension and BNP reflects the degree of ventricular remodeling in patients with hypertension.