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目的:探讨原发性高血压(EH)患者脑钠肽(BNP)水平与左室几何构型、左室功能的关系。方法:应用荧光免疫法快速测定EH组(106例)和对照组(46例)的血浆BNP浓度,根据心脏彩色超声检测结果,依照左室重量指数(LVMI)、相对室壁厚度(RWT)将106例EH患者分为:正常构型亚组(12例)、向心性重构亚组(9例)、离心性肥厚亚组(64例)、向心性肥厚亚组(21例)。应用相关性分析了解EH组LVMI、RWT、年龄、血压、体质指数(BMI)、左室射血分数(LVEF)等因素与BNP关系。结果:在EH各构型亚组中LVMI以离心性肥厚亚组最高,向心性肥厚亚组、离心性肥厚亚组BNP水平较对照组升高明显。EH组LVMI与BNP具有明显的正相关性(r=0.605,P<0.01),RWT与BNP具有明显的负相关(r=-0.266,P<0.01),LVEF与BNP呈负相关(r=-0.552,P<0.01),LVMI、RWT与血压、BMI之间无明显相关性。结论:EH组中不同的左室几何构型对BNP水平产生不同影响,具有更高的LVMI值和更低的LVEF、RWT值患者,BNP水平更高,而年龄、血压、BMI与BNP、LVMI、RWT无明显相关性。
Objective: To investigate the relationship between plasma BNP level and left ventricular geometric configuration and left ventricular function in patients with essential hypertension (EH). Methods: Plasma BNP levels in EH group (106 cases) and control group (46 cases) were determined rapidly by fluorescence immunoassay. According to the color Doppler echocardiography, LVMI, RWT Sixty-six patients with EH were divided into normal subgroup (n = 12), radial concentric subgroup (n = 9), eccentric hypertrophy subgroup (n = 64) and concentric hypertrophy subgroup (n = 21). Correlation analysis was used to analyze the relationship between LVMI, RWT, age, blood pressure, body mass index (BMI), left ventricular ejection fraction (LVEF) and BNP in EH group. Results: LVMI was the highest in subgroup of eccentric hypertrophy in all subgroups of EH, BNP in subgroup of concentric hypertrophy and eccentric hypertrophy was significantly higher than that of control group. There was a significant positive correlation between LVMI and BNP in EH group (r = 0.605, P <0.01), negative correlation between RWT and BNP (r = -0.266, P <0.01), and negative correlation between LVEF and BNP 0.552, P <0.01). There was no significant correlation between LVMI, RWT and blood pressure and BMI. CONCLUSIONS: Different left ventricular geometric configurations in EH group have different effects on BNP levels, with higher LVMI and lower LVEF. Patients with RWT have higher BNP levels, while age, blood pressure, BMI and BNP, LVMI , RWT no significant correlation.