高血压左心室肥厚患者血浆和肽素的变化及意义

目的探讨原发性高血压左心室肥厚患者血浆和肽素水平的变化及意义。方法 2013年4月1至2013年10月31日连续入选原发性高血压患者82例,采用动态血压仪进行动态血压监测,行超声心动图检测室间隔厚度、左室舒张末期内径和左室后壁厚度,计算左心室质量指数,将患者分为左心室肥厚组（LVH,n=38）与非肥厚组（NLVH,n=44）另选取40名健康体检者作为对照组,检测三组患者血浆和肽素水平,分析其与LVMI、BMI和血压的关系。结果 LVH组血浆和肽素水平（1 218.91±90.48）ng·L-1高于非肥厚组（1 018.22±84.31）ng·L-1,差异具有统计学意义（P〈0.05）。多元线性回归表明,和肽素与平均收缩压、平均舒张压和LVMI呈正相关（P〈0.05）。结论和肽素与血压水平及左室肥厚程度呈正相关,可能是高血压严重程度的预测因子。

Level and clinical significance of copepetin in the hypertensive patients with or without left ventricular hypertrophy

Objective To investigate the level of serum copeptin in hypertensive patients with or without left ventricular hypertrophy.Methods Eight-two consecutively enrolled patients with primary hypertension underwent measurement of ambulatory blood pressure between 1st Apr and 31st Oct of 2013.Left ventricular mass index（LVMI） was calculated from data obtained by 2-dimensionally guided M-mode echocardiography.40 healthy persons were enrolled as control.Results Patients with LVH reported higher serum copeptin level than those non-LVH patients（1218.91 ± 90.48 vs 1018.22 ± 84.31 ng·L-1）.In a multivariate regression analysis in which age,sex,body mass index,average systolic blood pressure（ASBP） and average diastolic blood pressure（ADBP） were included,ASBP,ADBP and LVMI were significant correlated with serum copeptin level（r2= 0.926）.Conclusions Copeptin added prognostic information in the prediction of left ventricular hypertrophy in patients with primary hypertension.