老年高血压血浆脑钠肽与动态血压及左心室肥厚的关系

目的 观察老年原发性高血压（EH）患者血浆脑钠肽（BNP）及24 h动态血压的变化,探讨老年EH患者24 h血压昼夜变化与BNP及左心室肥厚（LVH）的关系.方法 收集2011年9月～2013年9月内蒙古医科大学附属医院老年病科EH患者,按年龄分为老年组（≥65岁）106例,对照组（35～＜65岁）60例.观察两组患者血浆BNP及24 h动态血压,彩色多普勒超声检测LVH、左室舒张末内径（LVDD）并计算左室质量指数（LVMI）,分析老年不同类型血压变异与BNP、LVMI的关系.结果 ①老年组非杓型及LVH患者所占比例（42.5％,53.8％）均明显高于对照组（30.0％,36.7％）,差异均有统计学意义（均P＜ 0.05）.②老年组非杓型患者的BNP、LVMI及LVDD均明显高于老年组杓型者及对照组非杓型者,差异均有统计学意义（P＜ 0.05或P＜0.01）;老年组杓型患者BNP水平明显高于对照组（P＜0.05）,且老年组BNP与EVMI呈正相关（r=0.37,P＜0.05）.③老年组不伴有LVH的非杓型患者BNP较杓型者明显升高,差异有统计学意义（P＜0.05）.④老年组患者BNP水平在不同性别间差异无统计学意义（P＞0.05）.结论 血浆BNP水平能较好地反映老年高血压患者血压变异性及左心室重构,血浆BNP水平在老年高血压不同性别的患者间无明显差异.

Plasma brain natriuretic peptide lever between ambulatory blood pressure and left ventricular hypertrophy in elderly hypertension

Objective To observe the changes of plasma brain natriuretic peptide （BNP） and 24 hours ambulatory blood pressure of elderly patients with essential hypertension （EH）,and study the relationship between 24 hours dynamic blood pressure （BP） and BNP,left ventricular hypertrophy （LVH） in elderly hypertension patients.Methods Patients with EH from September 2011 to September 2013 in Gerontology Department of the Affiliated Hospital of Inner Mongolia Medical University were collected.EH patients were divided into aged group （≥ 65 years） with 106 cases and control group （35-＜ 65 years） with 60 cases according to the age.The plasma BNP and 24 h ambulatory BP of two groups were detected,the left ventricular diastolic diameter and （LVDD） and LVH were detected by color doppler ultrasound and the left ventricular mass index （LVMI） were calculated,the relationship between diurnal change rule of BP and BNP and LVMI were analyzed.Results ①The ratio of non-dipper and LVH in aged group （42.5％,53.8％）were higher than those in control group （30.0％,36.7％）,the differences were statistically significant （all P ＜ 0.05）.②BNP,LVMI and LVDD in patients with non-dippers in aged group were higher than patients with dippers in aged group and non-dippers in control group （P ＜ 0.05 or P ＜ 0.01）,BNP of patients with dippers in aged group was higher than that in control group while dippers had only markedly higher level of plasma BNP than control group （P ＜ 0.05）,there was a significant positive correlation between BNP levels and LVMI （r=0.37,P ＜ 0.05）.③Plasma BNP lever of patients with non-dippers and without LVH was significantly increased compared with patients with dippers,the differences was statistically significant （P ＜ 0.05）.④Plasma BNP level in aged group had no significant difference between the men and women （P ＜ 0.05）.Conclusion The level of plasma BNP can better reflect the BP variety and left ventricular reconstruction in elderly hypertensive,there is no obvious difference in plasma BNP between elderly hypertensive with different gender.