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目的研究原发性高血压患者N端脑钠肽前体(N-terminalpro-brainnatriureticpeptide,NT-proBNP)水平及其与左心室扩大和心功能的关系。方法测定原发性高血压患者64例血清NT-proBNP浓度,用心脏彩色多普勒检查测定其左心室舒张末径、左心室射血分数及二尖瓣血流E峰速度与A峰速度的比值(E/A)。结果血浆NT-proBNP浓度在左心室扩大组为(0.33±0.23)μg/L,显著高于左心室正常组(0.12±0.07)μg/L,差异有统计学意义(P<0.01);在重度高血压组为(0.25±0.19)μg/L,较轻中度高血压组(0.14±0.14)μg/L增高,差异有统计学意义(P<0.05);伴有舒张功能不全的高血压患者其血清NT-proBNP浓度和舒张功能正常者相比也有升高的趋势,但差异无统计学意义。血清NT-proBNP浓度与年龄(r=0.40,P<0.01)和左心室舒张末径(r=0.55,P<0.01)呈正相关,与射血分数呈负相关(r=-0.37,P<0.01)。结论NT-proBNP可以作为高血压患者左心室扩大及收缩功能下降的指标,其与舒张功能的关系值得进一步的研究。
Objective To investigate the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with essential hypertension and its relationship with left ventricular enlargement and cardiac function. Methods The serum levels of NT-proBNP were measured in 64 patients with essential hypertension. The left ventricular end-diastolic diameter, left ventricular ejection fraction and mitral flow E peak velocity and A peak velocity were measured by color Doppler echocardiography Ratio (E / A). Results The plasma concentration of NT-proBNP in the left ventricular enlargement group was (0.33 ± 0.23) μg / L, significantly higher than that in the normal left ventricle group (0.12 ± 0.07) μg / L, the difference was statistically significant (P <0.01) (0.25 ± 0.19) μg / L in hypertension group and 0.14 ± 0.14 μg / L in mild and moderate hypertension group (P <0.05). In hypertensive patients with diastolic dysfunction The serum NT-proBNP concentration and diastolic function than those who also have an upward trend, but the difference was not statistically significant. Serum NT-proBNP concentration was positively correlated with age (r = 0.40, P <0.01) and left ventricular diastolic diameter (r = 0.55, P <0.01), and negatively correlated with ejection fraction (r = -0.37, ). Conclusion NT-proBNP can be used as an index of left ventricular enlargement and systolic function decline in patients with hypertension, and its relationship with diastolic function deserves further study.