高血压病患者血浆脑钠肽水平与左室质量比值的关系

目的:探讨高血压病患者血浆脑钠肽(BNP)水平与左室质量比值(%PLM)的关系,并了解前者在高血压发生、发展过程中的变化。方法:选取61例原发性高血压患者,依据左室质量比值分为左室质量不足组11例,左室质量适宜组(aLVM)29例,左室质量过高(iLVM)组21例。30例同期住院血压正常检查者为对照组。测定血浆脑钠肽含量,行超声心动图检查,计算左室实际质量,左室质量预计值。结果:高血压组与对照组间BNP有显著性差异(P<0.01),且高血压各组间BNP也有显著性差异,以iLVM组最高,左室质量不足组与对照组间BNP无明显差异(P>0.05);BNP与左室质量比值呈正相关(r=0.499),与E/A比值呈负相关(r=-0.262);与LNEF、FS、左房大小、SBP、DBP没有相关性。结论:高血压病时血浆BNP升高,与左室质量比值呈正相关,BNP与高血压左室重构的发生、发展有关并可以作为判断高血压病预后的一项无创生化指标。

Relationship of Brain Natriuretic Peptide and the Ratio of Left Ventricular Mass in Patients with Hypertension

Objective:To investigate the relationship between the levels of plasma brain natriuretic peptide(BNP) and the ratio of predicted left ventricular mass(%PLM),and to find out the changes o BNP in development of essential hypertension(EH).Methods: 61 patients of EH were selected and divided into four groups by %PLM: group with inadequate left ventricular mass(n=11),group with adequate left ventricular mass(aLVM)(n=29),inappropriately high left ventricular mass(aLVM)(n=21),and control group(n=30).The levels of plasma BNP was detected and the echocardiography was performed,for calculating actual left ventricular mass and predicted left ventricular mass.Results: The level of plasma BNP was significantly different between EH group and control group,or among groups with EH,which was highest in iLVM group.The level of plasma BNP showed no difference between group with inadequate left ventricular mass and control group(P>0.05).The level of BNP was positively correlated with %PLM(r=0.499) and negatively correlated with E/A ratio(r=-0.262),but not correlated with LVEF,FS,the size of left atrium,SBP and DBP.Conclusion: The level of plasma BNP raises by EH,which is positively related to %PLM,BNP is relevant to the development of left ventricular reconstitution.BNP may be a biochemical index without trauma for the prognosis of EH.