老年原发性醛固酮增多症高血压患者的脑钠肽前体水平及与LVMI和激活醛固酮水平的相关性

摘要

目的 分析原发性醛固酮增多症引起老年高血压患者 N末端B型脑钠肽前体(N terminal pro_B_type natriuretic peptide,NT_proBNP)水平及与左心室质量指数(left ventricular mass index,LVMI)和激活醛固酮水平的相关性.方法 将98例老年高血压患者作为研究对象,其中46例原发性醛固酮增多症为观察组,52例原发性高血压为对照组,分析两组NT_proBNP、LVMI水平及其与激活醛固酮水平的相关性.结果 观察组log NT_proBNP水平(1.95 ± 0.37)g/m2高于对照组(1.71 ± 0.38)g/m2(P<0.05),LVMI水平(117.95 ± 17.36)g/m2亦高于对照组(105.96 ± 15.97)g/m2(P<0.05),且其左心室肥厚比例(67.39%)亦高于对照组(51.92%)(P<0.05).多元线性逐步回归分析显示,观察组NT_proBNP水平与LVMI和激活醛固酮水平密切相关,而对照组NT_proBNP水平与患者收缩压水平密切相关.结论 原发性醛固酮增多症容易引起高血压老年患者NT_proBNP水平上升,且NT_proBNP水平与LVMI和激活醛固酮水平密切相关.%Objective To analyze the association of N terminal pro_B_type natriuretic peptide(NT_proBNP)levels with left ventricu-lar mass index(LVMI)and activation of aldosterone levels in elderly patients with primary aldosteronism causing hypertension.Meth-ods 98 elderly patients with hypertension were collected,including 46 cases of primary aldosteronism as the observation group and 52 cases of primary hypertension as the control group.The levels of NT_proBNP and LVMI were measured in the two groups and their correlations with activation of aldosterone levels were analyzed.Results The level of log NT_proBNP[(1.95 ± 0.37)g/m2]in the ob-servation group was significantly higher than that in the control group[(1.71 ± 0.38)g/m2](P<0.05).The level of LVMI[(117. 95 ± 17.36)g/m2]was significantly higher than that in the control group[(105.96 ± 15.97)g/m2](P<0.05),and the ratio of left ventricular hypertrophy(67.39%)was also significantly higher than that in the control group(51.92%)(P<0.05).The re-sult of multiple linear stepwise regression analysis showed that the levels of NT_proBNP in the observation group were closely related to LVMI and the activation of aldosterone levels,while the levels of NT_proBNP in the control group were closely related to the levels of systolic blood pressure.Conclusions Primary aldosteronism is liable to increase the levels of NT_proBNP in elderly patients with hy-pertension and the levels of NT_proBNP are closely related to LVMI and activation of aldosterone levels.