老年轻中度高血压患者血清脑利钠肽水平与左室重构的关系

摘要

目的 观察老年轻中度高血压患者血清BNP水平与左室重构之间的关系.方法 175例高血压患者根据超声心动图检查结果分为4个亚组:正常构型组35例,向心性重构型组50例,向心性肥厚型组50例,离心性肥厚型组40例;另将50例无高血压的健康人设为健康对照组.用ELISA法测定血清BNP浓度.结果 (1)高血压病组的BNP水平显著高于健康对照组(P<0.05);向心性肥厚组与离心性肥厚组的BNP水平均明显升高,且显著高于其他2组(P<0.05),但2个肥厚组间差异无统计学意义(P>0.05);高血压正常构型与向心性重构型组的BNP水平虽高于健康对照组,但差异无统计学意义(P>0.05).(2)血浆BNP与左室质量指数、左心室室壁相对厚度、室间隔厚度和左室后壁舒张末期厚度呈显著正相关(P<0.05),与左室射血分数(LVEF)呈负相关(P<0.05).结论 有左室重构的高血压患者血清BNP水平明显升高,血清BNP水平与左室重量指数和平均室壁厚度有相关性.血清BNP水平能反映高血压患者左室重构的存在及其程度;检测血清BNP浓度可能有助于发现高血压左室结构的异常.%Objective To investigate the relationship between the level of B-type natriuretic peptide ( BNP ) and left ventricular remodeling in elderly patients with mild and moderate hypertension. Methods Consecutive 175 patients with hypertension were divided into four groups according to their echocardiography performance: normal geometry group( n =35 ); concentric remodeling group( n = 50 ); concentric hypertrophy group( n = 50 ); eccentric hypertrophy group( n = 40 ). 50 healthy people without hypertension were enrolled as the control group. The plasma concentration of BNP was measured by ELISA. Results ( 1 ) The plasma concentration of BNP in hypertensive patients was obviously higher than that in the control group( P <0. 05 ). The level of BNP in the concentric hypertrophy group and eccentric hypertrophy group was obviously higher than those in other groups ( P <0.05 ). While no distinct was observed between the two hypertrophy groups statistically ( P > 0. 05 ). The level of BNP in the normal structure group and remodeling group was higher than those in the normal group, while the difference was no statistical significance ( P >0. 05 ). ( 2 ) The level of plasma BNP was positively correlated with left ventricular mass index ( LVMI ), relative wall thickness ( RWT ), interventricular septal thickness ( IVST )and left ventricular posterior wall thickness ( LVPWT, all P <0. 05 ), and negatively correlated with left ventricular ejection fraction ( LVEF,P < 0. 05 ). Conclusion The level of BNP was significantly higher in the hypertensive patients with left ventricular remodeling. The plasma BNP was correlated with LVMI and RWT. The level of the plasma BNP could reflect the possibility of left ventri cular remodeling and its severity, and the detection of BNP was helpful to validate the abnormality of left ventricular in hypertensive patients.