烧伤后多系统脏器衰竭患者血浆AⅡ、ANP、AⅡ/ANP水平及临床意义

对烧伤面积（TBSA）＞20％患者59例（其中单脏器功能衰竭6例，多脏器功能衰竭14例）进行前瞻性临床研究。方法：连续测定了血浆血管紧张素Ⅱ（AⅡ）和心房肽（ANP）及血N－乙酰－β－D－氨基葡萄糖苷酶（NAG）活性,以探讨AⅡ／ANP失衡在严重烧伤后多脏器衰竭中的作用。结果：严重烧伤后存在着AⅡ／ANP明显失衡，与烧伤严重程度、低血容量休克、全身性感染有关。MOF患者AⅡ／ANP显著高于non-MOF者，AⅡ／ANP与NAG活性呈显著正相关。结论：AⅡ／ANP在MOF发生发展中起着重要作用。AⅡ／ANP及NAG也是反映烧伤后MOF病情及预后的重要参考指标。     

Perinatal hypoxia causes ventricular enlargement associated with increased atrial natriuretic peptide (ANP) mRNA levels in newborn mice

We sought to examine both the short-term and residual effects of perinatal hypoxia on ventricular mass and function of mice. We postulated that the magnitude of the ventricular hypertrophy would be determined by the timing of the exposure, be linked to augmented atrial natriuretic peptide (ANP) expression, and would persist to young adulthood. Furthermore, mice deficient in the ANP receptor type A (ANPRA) would have even greater hypertrophy. Newborns were placed in a 12% oxygen (O(2)) chamber either shortly after birth or at 8 days of age. Controls were raised in room air. After 8 or 16 days, pups were terminated and the right ventricle (RV) and left ventricle including the septum (LVS) were excised and weighed and total RNA was extracted. Hypoxia caused a reduction in body weight (BW) with an increase in right ventricle (RV) weight, rendering an increased RV to BW ratio and increased LVS/BW, albeit less. Hypertrophy was most pronounced in pups exposed to hypoxia in the first days of extrauterine life. A rapid postnatal decline in both RV and LVS ANP mRNA levels was observed in control animals, while the hypoxia elevated ANP mRNA. In mice missing the ANPRA, both ventricles were more massive than in wild type and hypoxia further augmented RV/BW and LVS/BW. In normal adult animals returned to room air after 16 days of hypoxia, RV but not LVS hypertrophy persisted in both sexes; there was an interaction between gender and the perinatal hypoxic stress on LVS dimension and perhaps on contractility. Thus perinatal hypoxia may "program" the adult mouse heart and vasculature.     

Serum atrial natriuretic peptide (ANP) as an objective indicator for the diagnosis of neurogenic shock: animal experiment and human case report

In forensic medicine, the diagnosis of death due to neurogenic shock is considered to be an aporia, as lacking objective indicators and presenting atypical symptoms in autopsy. Medico-legal disputes and complaints occasionally result from this ambiguity. To explore potential objective indicators of neurogenic shock, we set up a model of neurogenic shock by applying an external mechanical force on the carotid sinus baroreceptor in rabbits. The serum atrial natriuretic peptide (ANP) level was measured by radioimmunoassay in the control group (n = 8), survival group (n = 15) and death group (n = 5) both before and after the insult. The serum ANP level showed a significant increase after the insult in the death group compared with the serum obtained before the insult (P = 0.006), while the serum ANP level after the insult in the survival group and control group was not statistically significant compared with the serum obtained before the insult (P = 0.332 and P = 0.492, respectively). To verify the repeatability of the model and the postmortem behavior of serum ANP, five healthy adult rabbits underwent the same procedure as the experimental group. The mortality rate was consistent with the former experiment (20 %). There were no significant changes in serum ANP level in vitro and in vivo (within 48 and 24 h, respectively). But there was a significant decrease in serum ANP level at 48 h postmortem in vivo (P = 0.001). A female patient who expired due to neurogenic shock during a hysteroscopy was reported. Neither fatal primary disease nor evidence for mechanical injuries or intoxication was found according to the autopsy. The serum ANP level was assayed as a supplementary indicator and was found to be three-fold higher than the normal maximum limit. Combined with the animal experiment, this case highlights that serum ANP has the potential to be an objective indicator for the diagnosis of death due to neurogenic shock.

     

Radioimmunometric assay of natriuretic peptide type-B (BNP) in heart failure

The aim of this study was to assess the value of the radioimmunometric determination of natriuretic peptide type-B (brain natriuretic peptide, BNP) in the diagnosis and prognosis of heart failure, and to study the association between BNP and the clinical, analytical and echocardiographic variables associated with the evolution of heart failure. The study group included 169 patients (74 women and 95 men; mean, 66 years) with heart failure of different causes, admitted consecutively to our hospital. BNP levels were measured with a radioimmunometric assay (Shionora BNP Cis ) after day 3 of admission. Patients were also studied by echocardiography. A significant association between the cause of heart failure and the BNP concentration was found (patients with ischaemic disease had the highest BNP values). Systolic function was worse in patients with ischaemic disease or dilated cardiomyopathy. High BNP values were also associated with advanced functional class and male sex. Plasma creatinine correlated positively with plasma BNP. However, we found no significant association with the other clinical variables evaluated. Of the echocardiographic variables analysed, BNP correlated positively with the ventricular diameter and pulmonary artery systolic pressure, and inversely with the shortening fraction; patients with severely impaired systolic function had the highest BNP values. It can be concluded that BNP levels (by radioimmunometric assay) are increased in patients with heart failure, and increase in relation to left ventricular dysfunction and the severity of heart failure. The strong independent association of plasma BNP with the left ventricular ejection fraction, its stability and the low cost of measurement suggest that plasma BNP assay could become a routine test. BNP assay could be included as an important factor in clinical and therapeutic decision making, as it complements the information provided by other variables used in the diagnosis of heart failure.     

Evaluation and comparison of the analytical performances of two RIA kits for the assay of atrial natriuretic peptides (ANP)

We evaluated the analytical performance of two commercial RIA kits for the assay of plasma atrial natriuretic peptide (ANP), which use different antisera and tracers, in order to verify the most suitable RIA procedure for the assay of ANP in plasma samples. In particular, two different procedures for the purification of plasma were evaluated. The first one uses the extraction of plasma samples with Sep-Pack C18 cartridges and the second immunoextraction (C-terminal ANP-specific antibody bound to solid phase of Sepharose). The sensitivity and precision of the two RIA kits proved inadequate, being unable to provide an acceptably precise measurement of the plasma ANP concentrations in normal subjects. An improvement in precision and sensitivity was obtained by using "fresh" (or purified) preparations of the tracer and standard solutions, and by adding PEG to the B/F separation step. The direct assay (without preliminary purification) was not possible due to a serious overestimation of plasma levels due to the presence of interferences; on the other hand, the extraction step increased the imprecision and the complexity of the assay. Moreover, the extraction recovery of ANP added to plasma samples in the procedure using Sep-Pak cartridges is about 50-60%, while it was found to be almost complete (about 90%) in the immunoextraction procedure. Moreover, a comparison of the results obtained with the two RIA systems indicated that the antisera have comparable sensitivities, but quite different specificities; however, neither of the two RIA kits showed a completely satisfactory degree of sensitivity, precision and practicability.     

Alterations of atrial natriuretic peptide in cardiomyocytes and plasma of rats after different intensity exercise

To characterize the effect of long-term exercise training at different intensities on endocrine structure and function of the heart, plasma atrial natriuretic peptide (ANP) levels, expression of ANP in cardiomyocytes, and ultrastructure of cardiomyocytes were examined by radioimmunoassay, immunohistochemistry and transmission electron microscopy in Sprague-Dawley rats trained on a treadmill at different intensities for 8 weeks. The plasma ANP increased gradually with increasing exercise intensity. The immunoreactivity of ANP in cardiomyocytes increased in the moderate- and high-intensity exercise group and decreased in the exhaustive exercise group. The ANP electron-dense granules and the quantity and volume of mitochondria increased in moderate and high-intensity exercise group. The ANP electron dense granules decreased and the mitochondria tumefied in the exhaustive exercise group. The changes of plasma ANP have a tendency of increasing gradually with increase in exercise intensity. Moderate and high-intensity exercise increases ANP synthesis and storage in cardiomyocytes and induces adaptive changes in the ultrastructure of cardiomyocytes. The decrease of ANP immunoreactivity in cardiomyocytes after exhaustive exercise is probably the result of massive depletion and induces damaging changes in the ultrastructure of cardiomyocytes.     

舒张性心力衰竭患者血清N末端-脑钠肽前体水平检测分析

目的探讨舒张性心力衰竭（DHF）患者血清N末端-脑钠肽前体（NT-proBNP）水平的变化及临床意义。方法选择63例失代偿性DHF患者为DHF组,40例无器质性心脏病者为对照组。所有受试者均采用NYHA分级法分级诊断心功能,电化学发光双抗体夹心免疫法检测血清NT-proBNP水平,心脏彩色多普勒超声测定左心室舒张功能。对比两组的血清NT-proBNP水平,分析DHF患者血清NT-proBNP水平与NYHA心功能级别和左心室舒张功能障碍程度的关系。结果 DHF组患者血清NT-proBNP水平显著高于对照组（P〈0.05）,并随NYHA心功能级别增高和舒张功能障碍程度加重而升高（P〈0.05）。结论血清NT-proBNP水平能在一定程度上反映失代偿性DHF患者的心功能状态,有助于DHF的诊断和病情评估。     

Flight influence on the plasma level of renin-angiotensin-aldosterone system and atrial natriuretic peptide

Plasma levels of the renin-angiotensin-aldosterone system (RAAS) and atrial natriuretic peptide (ANP) were studied in healthy male pilots, and in a ground crew control group. Plasma concentrations of angiotensin I (A I), angiotensin II (A II) and aldosterone (Aldo) were measured in the pilots before and after flight by radioimmunoassay. Results showed that the plasma concentrations of A I, A II, and Aldo were much higher after flight than before flight, and were different from samples taken from the control group (p less than 0.001). On the other hand, the ANP levels in the pilot group did not differ significantly from the control group, before or after flight. There was no significant difference of the four hormones within the control group over the course of the study. This suggests that the development of hypertension in pilots may relate to the reaction of the RAAS.     

Effects of intravenous atrial natriuretic peptide on cardiac sympathetic nerve activity in patients with decompensated congestive heart failure.

The activation of the renin-angiotensin-aldosterone system (RAAS) prevents the uptake of norepinephrine in the myocardium. Atrial natriuretic peptide (ANP), a circulating hormone of cardiac origin, has vasodilatory and diuretic properties and can inhibit the RAAS. However, its effect on cardiac sympathetic nerve activity has not been determined. METHODS: We studied 58 patients with decompensated nonischemic acute heart failure who were treated with intravenous low-dose dopamine and diuretics. Twenty-nine patients (group A) were assigned to also receive intravenous ANP, whereas the remaining 29 patients (group B) continued their established drug regimen. The dopamine or ANP was continuously infused for >96 h. The left ventricular end-diastolic volume and ejection fraction were determined by echocardiography before and 4 wk after treatment. The delayed heart-to-mediastinum (H/M) count ratio, delayed total defect score, and washout rate were determined from (123)I-metaiodobenzylguanidine (MIBG) images 3 wk after treatment. RESULTS: Fifty-six patients enrolled in the trial completed the entire protocol. After treatment of group A (n = 28), the left ventricular end-diastolic volume decreased from 186 +/- 42 to 174 +/- 48 mL (P < 0.05), and left ventricular ejection fraction increased from 32% +/- 9% to 36% +/- 7% (P < 0.05). In group B (n = 28), these parameters did not change significantly. In addition, 3 wk after treatment of group A, the total defect score was significantly lower (30 +/- 9 vs. 38 +/- 9, P < 0.01), the H/M count ratio was significantly higher (1.86 +/- 0.21 vs. 1.62 +/- 0.23, P = 0.0001), and washout rate was significantly lower (42% +/- 12% vs. 49% +/- 12%, P < 0.05) than in group B. CONCLUSION: The present study demonstrates an improvement in echocardiographic parameters with ANP infusion. In addition, cardiac (123)I-MIBG scintigraphic parameters were better in patients who received ANP infusion along with dopamine and diuretics than in patients who received standard conventional therapy. These findings indicate that intravenous administration of ANP can benefit cardiac sympathetic nerve activity and improve left ventricular remodeling in patients with acute heart failure.     

Radioimmunometric assay of B-type natriuretic peptide (BNP) in heart transplantation: correlation between BNP determinations and biopsy grading of rejection

The aim of this study was to determine whether elevated brain natriuretic peptide (BNP) levels after heart transplantation are correlated with the severity of rejection by using endomyocardial biopsy (EMB) and echocardiographic parameters indicative of ventricular function of the transplanted heart. This was an observational study of 80 orthotopic heart transplant recipients (11 women and 69 men; mean age 53+/-11 years). BNP determinations were performed within 48 h of endomyocardial biopsy. The echocardiographic study and BNP determination were also performed in a group of healthy volunteers. We found significantly higher BNP mean levels in heart transplant patients than in healthy volunteers (volunteers, 16.7+/-16.2 pg.ml-1; transplant, 213.4+/-268.6 pg.ml-1; P<0.001). Transplant recipients with rejection grades 2, 3 and 4 on EMB had significantly higher BNP levels than those with rejection grades 0 and 1 (higher rejection grade, 162.5+/-168.4 pg.ml-1; lower rejection grade, 292+/-361.8 pg.ml-1; P<0.01). BNP values of patients with good left ventricular function (LVF) were significantly lower than in patients with mildly and moderately impaired LVF and patients with severely impaired LVF (good function, 199.76+/-233.6 pg.ml-1; mildly/moderately impaired LVF, 937+/-644.5 pg.ml-1; severely impaired LVF, 1038+/-491.2 pg.ml-1; P<0.001). It is concluded that BNP plasma levels are elevated in heart transplant patients compared to the normal population. The distribution of BNP levels in heart transplanted patients show a wide range. BNP elevation is greater in patients with higher rejection grades on EMB and greater impairment of left ventricular function.     

Evaluation of cardiac sympathetic nerve activity and aldosterone suppression in patients with acute decompensated heart failure on treatment containing intravenous atrial natriuretic peptide

Purpose

Aldosterone prevents the uptake of norepinephrine in the myocardium. Atrial natriuretic peptide (ANP), a circulating hormone of cardiac origin, inhibits aldosterone synthase gene expression in cultured cardiocytes. We evaluated the effects of intravenous ANP on cardiac sympathetic nerve activity (CSNA) and aldosterone suppression in patients with acute decompensated heart failure (ADHF).

Methods

We studied 182 patients with moderate nonischemic ADHF requiring hospitalization and treated with standard therapy containing intravenous ANP and 10 age-matched normal control subjects. ANP was continuously infused for >96 h. In all subjects, delayed total defect score (TDS), heart to mediastinum ratio, and washout rate were determined by ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy. Left ventricular (LV) end-diastolic volume, end-systolic volume, and ejection fraction were determined by echocardiography. All patients with acute heart failure (AHF) were examined once within 3 days and then 4 weeks after admission, while the control subjects were examined only once (when their hemodynamics were normal). Moreover, for 62 AHF patients, plasma aldosterone concentrations were measured at admission and 1 h before stopping ANP infusion.

Results

¹²³I-MIBG scintigraphic and echocardiographic parameters in normal subjects were more favorable than those in patients with AHF (all p?<?0.001). After treatment, all these parameters improved significantly in AHF patients (all p?<?0.001). We also found significant correlation between percent changes of TDS and aldosterone concentrations (r?=?0.539, p?<?0.001) in 62 AHF patients.

Conclusion

The CSNA and LV performance were all improved in AHF patients. Furthermore, norepinephrine uptake of myocardium may be ameliorated by suppressing aldosterone production after standard treatment containing intravenous ANP.     

Preparation of mono-radioiodinated tracers for study of the in vivo metabolism of atrial natriuretic peptide in humans

In the present paper we evaluate the optimum chemical conditions for labelling atrial natriuretic peptide (ANP) and its metabolites and for preparing highly purified radiotracers which can be used for in vivo kinetic studies of ANP in humans. Synthetic a h_1–28ANP and some hormone metabolites were iodinated with Na¹²⁵I or Na¹³¹I by means of the lactoperoxidase (ANP) or the chloramine-T (ANP metabolites) technique. The biological activity of labelled ANP was tested by means of a binding study using mouse cardiac membranes. A high-performance liquid chromatography (HPLC) procedure was used to purify the labelled hormone and the principal labelled metabolites in venous plasma samples collected up to 50 min after the injection of¹²⁵I-labelled ANP from nine healthy men. The main ANP kinetic parameters were derived from the disappearance curves of the [¹²⁵I]ANP, which were satisfactorily fitted by a biexponential function in all subjects. The main advantages of this tracer technique are: (1) high accuracy, allowing the identification of the metabolites produced in vivo under steady-state conditions after injection of the precursor (labelled hormone); (2) high sensitivity, allowing the detection of minimal quantities of metabolites (that cannot be identified on the basis of the integrated areas from the ultraviolet-absorbing peaks on HPLC); (3) high specificity, allowing the detection of possible in vitro artefactual generation of cleavage products of ANP using an internal labelled standard. Utilizing this tracer method, it was possible to estimate the principal parameters of ANP kinetics and also to plot the appearance curves of the labelled metabolites produced in vivo after the injection of the labelled precursor.     

Effects of ionizing radiation on gene expression in cultured rat heart cells

PURPOSE: To determine the in vitro effect of ionizing radiation on TGF-beta1, FGF-2, IL-1beta, atrial natriuretic peptide (ANP) and procollagen types I and III gene expression in three different cell types of rat heart. MATERIALS AND METHODS: Primary cell cultures of myocytes and fibroblasts and cultures of a rat heart endothelial cell line (RHEC) were irradiated with single doses of 2.0, 8.5 or 15 Gy. At different time-points after irradiation (4-336 h), gene expression was analysed using a competitive PCR technique. RESULTS: Irradiation of cultured rat heart cells may lead to temporary changes in expression of the genes studied. Analysis of the radiation response of cultured myocytes, cardiac fibroblasts and rat heart endothelial cells reveals different responses with regard to (1) the dose necessary to evoke changes in mRNA expression, (2) the level of and (3) the duration of the 'induced' response. The changes observed were small and between parallel experiments the onset and time-course of the induced gene expression varied between 4 and 48 h. The average expression of TGF-beta1 mRNA between 4 and 48 h was significantly elevated in endothelial cells after a dose of 2.0 Gy, in fibroblasts after a dose of 8.5 Gy and in myocytes after a dose of 15 Gy. Down-regulation of TGF-beta1 mRNA in myocytes was observed after a dose of 8.5 Gy. FGF-2 and procollagen type-I mRNAs were significantly elevated in fibroblasts after a dose of 2.0 Gy. For all three cell types, no effect of dose on the timing or size of the gene expression was observed. CONCLUSIONS: Although irradiation of cultured heart cells influences expression of genes involved in tissue remodelling, the observed differences were too small and too restricted in time and dose to explain the exact role of these cell types in processes leading to radiation-induced cardiac fibrosis.     

磺脲类药物受体亚型在缺血及缺血预适应大鼠心肌中的定位与分布研究

目的　探讨缺血再灌注及缺血预适应 (IPC)状态心肌磺脲类药物受体 (SUR)亚型SUR2的分布及表达特征。方法　建立大鼠心肌在体IPC模型及缺血再灌注模型 ,采用体外受体放射自显影技术检测正常对照、缺血再灌注及IPC时大鼠心肌中SUR2的定位与分布模式 ,并用图像分析仪对其表达密度作半定量分析。结果　①与对照区相比 ,缺血再灌注缺血区相对透光度增高 ,其平均增高幅度为 (4 1.0± 9.3) % ;②IPC区与对照区相比相对透光度也增高 ,其平均增高幅度为 (17 1±2 3) % ;③IPC组相对透光度增高幅度小于缺血再灌注组 (χ2 =5 .2 73,P <0 .0 5 )。结论　缺血再灌注及IPC时SUR2表达密度均降低 ,但后者降低幅度小于前者     

低氧及跑台运动训练对大鼠心房钠尿肽和胰岛素样生长因子的影响

 目的 观察低压低氧和跑台训练对大鼠血浆心钠素和血清胰岛素样生长因子的影响,为探讨高原低氧训练适应的习服提供实验数据.方法 雄性SD大鼠分为常氧对照组、常氧训练组、低氧对照组和低氧训练组.用MPA-心功能分析系统记录血压和心率,用放射免疫法测血浆心钠素和血清胰岛素样生长因子.结果 与常氧对照组比较,常氧运动组体重减少(P<0.05),血浆中的ANP和血清中的IGF-1升高(P<0.01).与低氧对照组比较,低氧运动组体重减少(P<0.01),血浆中ANP降低(P<0.05),血清中IGF-1降低(P<0.01).结论 运动或低氧单独刺激都使大鼠血清胰岛素样生长因子、血浆心钠素升高,低氧及运动结合刺激对大鼠血清胰岛素样生长因子和血浆心钠素的影响不显著.     

Radiation-induced variations in urothelial expression of intercellular adhesion molecule 1 (ICAM-1): association with changes in urinary bladder function

PURPOSE: To assess the effect of single-dose irradiation on intercellular adhesion molecule 1 (ICAM-1) expression in the urothelium of mouse urinary bladder and to correlate ICAM-1 variations with fluctuations in storage capacity during the early and late radiation response. MATERIALS AND METHODS: Groups of female C3H mice were subjected to irradiation with either 20 or 0 Gy. The intensity of immunohistochemical ICAM-1 staining in the urothelium was assessed in a semiquantitative way applying an arbitrary score (0-5). Changes in bladder storage function were assessed by transurethral cystometry. RESULTS: For the early radiation response phase, a reduction in bladder capacity by >50%, i.e. a positive functional radiation response, was seen in 40% of the irradiated animals between days 0 and 15, and in 64% of animals during days 16-30. During the late response phase, 71% of the animals sacrificed after day 180 developed a positive functional response. Urothelial cells were found to express ICAM-1 constitutively. Irradiation resulted in an early rise in staining signal by day 2, with a maximum on day 4 and a return to control values on day 13. A permanent increase in ICAM-1 staining signal was observed in the late phase, from day 90 to 360 after irradiation. The expression of ICAM-1 in animals with a positive late response was 4.2+/-1.2 (mean+/-standard deviation), compared with 2.6+/-1.0 in non-responders (p=0.0009). CONCLUSION: Irradiation induces significant acute and chronic changes in urothelial ICAM-1 expression indicating that the urothelium contributes to the pathogenesis of both acute and late radiation effects in the urinary bladder.     

急性完全性颈髓损伤患者水钠代谢紊乱及血浆心钠素的变化

目的研究急性完全性颈髓损伤患者继发的水钠代谢紊乱及血浆心钠素的变化,并探讨其发生机制.方法选择1998年9月～2000年2月住院的骨科患者,分为颈髓损伤组28例,对照组18例.于不同时相点观察两组患者血清K     

心肺复苏期家兔血浆内皮素、心钠素、一氧化氮含量的变化

目的 :研究血浆内皮素 (ET)、心钠素 (ANP)、一氧化氮 (NO)在心脏骤停缺血 /再灌注损伤前后含量变化规律及意义。方法 :取家兔 4 0只分别分为对照组、实验组 ,制作家兔心脏骤停缺血 /再灌注模型 ,观察心肺复苏期各时相血浆ET、ANP、NO、血压及心电变化。结果 :动物在心脏骤停及复苏即刻血浆ET含量未见明显升高 (P >0 .0 5 ) ,而血浆ANP、NO水平降低 (P <0 .0 5 ) ,复苏后 0 .5h血浆ET明显升高 (P <0 .0 1) ,复苏后 2h血浆ET、ANP、NO均较复苏前有明显上升 (P <0 .0 5 )。结论 :在心脏骤停缺血 /再灌注损伤过程中ET、ANP、NO水平变化及相关关系可能是一种调节机制并在病理生理过程中起重要作用。     

老年原发性高血压患者BNP、hs-CRP与房颤关系的研究

目的探讨老年原发性高血压患者血清B型利钠肽(BNP)、高敏C反应蛋白(hs-CRP)水平与心房颤动之间的关系。方法对我院2008年10月—2011年10月连续诊治的老年原发性高血压患者209例,根据超声心动图(UCG)测量左室舒张末内径(LVEDD)、室间隔厚度(IVSD)、左室后壁厚度(LVPWD)、左室射血分数(LVEF)、左房内径(LA),计算左室质量指数(LVMI)。根据ECG将患者分为房颤组(AF组,105例)及无房颤组(NAF组,104例),测定两组患者的血清BNP、hs-CRP水平。结果 AF组中阵发性房颤48例,持续性房颤24例,永久性房颤33例。AF组患者的BNP[(198.66±118.85)ng/L与(86.37±66.96)ng/L]与LVMI[(127.19±28.04)g/m2与(83.70±17.23)g/m2]明显高于NAF组(P<0.01)。永久性房颤患者BNP明显高于阵发性房颤患者[(242.45±134.36)ng/L与(178.95±102.73)ng/L,P<0.05],而阵发性房颤、持续性房颤患者BNP无统计学差异(P>0.05);三组间hs-CRP均无统计学差异(P>0.05)。老年原发性高血压房颤患者BNP与患者LVMI、LA、房颤持续时间成正相关,与LVEF成负相关。Logistic回归分析表明,老年原发性高血压患者血清BNP水平升高,房颤的可能性增大。hs-CRP与房颤之间无相关性(P>0.05)。结论 BNP与老年原发性高血压房颤之间关系密切。BNP可作为老年原发性高血压左心室心肌肥厚的标志物。