脑钠肽前体在高血压合并左室肥厚及左室收缩功能异常中的变化

目的：检验高血压患者血浆脑钠肽前体与左室肥厚（LVH）、左室收缩功能异常（LVSD）的关系。方法：将76例高血压患者按照左室收缩功能情况及有尢LVH分为4组：左室收缩功能正常、无LVH者（A组）22例。左室收缩功能正常、存在LVH者（B组）24例，左室壁运动指数（LWMI）1．9～1．3者（C组）13例。LWMI〈1．2者（D组）17例，检测其脑钠肽前体浓度。选择15例超声心动检查正常者作为对照（E组）。结果：血浆脑钠肽前体浓度，C组、D组与A、B、E组比较均存在显著性差异（均P〈0．01），C组与D组间也存在显著性差异（P〈0．05）。结论：高血压患者，只要左室收缩功能正常，左室肥厚不影响血清脑钠肽前体浓度，发生LVSD时血浆脑钠肽前体浓度随之升高。因此，血浆脑钠肽前体可以成为明确高血压患者是否出现LVSD的一个有效指标．

Changes of plasma pro-brain natriuretic peptide levels in hypertensive patients with left ventricular hypertrophy and systolic dysfunction

Objective:To investigate the relationship between plasma pro-brain natriuretic peptide(pro-BNP) levels and left ventricular hypertrophy(LVH) and left ventricular systolic dysfunction(LVSD) in patients with hypertension.Methods:Ninety one subjects were recruited,including 15 healthy controls and 76 hypertensive patients.All the subject's plasma were taken for pro-BNP when they were examined the echocardiograms.They were divided into five groups according to the levels of blood pressure,left ventricular thickness and left ventricular systolic function:15 healthy controls(group 1),22 hypertensive patients without LVH and with normal left ventricular systolic function(group 2),24 hypertensive patients with LVH and with normal left ventricular systolic function(group 3),13 hypertensive patients with wall motion index(LWMI) 1.9~1.3(group 4)and 17 hypertensive patients with wall motion index(LWMI)<1.2(group 5).Results:The levels of plasma pro-BNP in groups 1-3 had significant differences from groups 4,5.Group 4 was markedly different from group 5(P<0.05).Conclusion:If hypertensive patients have normal systolic function,then LVH has no effects on the levels of plasma pro-BNP.When LVSD appears in hypertensive patients,then the level of plasma pro-BNP increases with the level of LVSD.Pro-BNP may be an effective predictor for the appearance of LVSD in hypertensive patients.