高血压病患者不同左心室功能状态与血浆脑利钠肽水平的相关性研究

目的:探讨高血压病患者脑利钠肽(BNP)水平与不同左心室功能的相关性.方法:高血压病患者206例,根据心功能情况分为心功能正常、舒张功能不全和收缩功能不全三组,并以87例正常体检者为对照组,对比血浆BNP水平.结果:高血压病患者根据心功能情况分组后,各组间血压水平无差异,与正常对照组间年龄、性别比差异无统计学意义(P>0.05);对照组、心功能正常组和舒张功能不全组之间EF值、左室舒张末内径无差异;BNP水平与对照组相比较,心功能正常组、舒张功能不全组和收缩功能不全组呈逐步升高,以收缩功能不全组最显著(P<0.001);收缩功能不全组BNP水平明显高于舒张功能不全组(P<0.01).结论:BNP可较好地反映高血压病患者左心室功能变化情况,在舒张功能出现时已有明显升高,左心室收缩功能不全时,升高最显著.对BNP水平的检测,可准确地对高血压病患者心脏功能状况进行判断和指导治疗.

STUDY ON THE RELATION BETWEEN B-TYPE NATRIURETIC PEPTIDE PLASMA AND VARIED TYPE OF HEART FAILURE IN PATIENTS WITH ESSENTIAL HYPERTENSION

Objective:To investigate the difference of brain natrivretic peptide (BNP) concentration in patients with difference heart function in essential hypertension patients. Methods:206 patients with essential hypertension who did not undergo regular anti-heart failure therapy and 87 control subjects were enrolled in this study. According to heart function of patients with hypertension were divided into normal heart function, left ventricular diastolic dysfunction and left ventricular systolic dysfunction three groups. Serum concentration of BNP were measured just before echocardiography.Result:BNP in patients with hypertension was significantly higher than in control group. BNP was highest in patients with left ventricular systolic dysfunction vs control group (P<0.001); followed by that of the patients with left ventricular diastolic dysfunction vs control group (P<0.005). On the other hand, BNP in the patients with left ventricular systolic dysfunction was higher than that of the left ventricular diastolic dysfunction group (P<0.01). Though higher than that of the controls, no significant difference of BNP was found in the normal heart function group. Conclusion:The BNP plasma levels were good markers used to reflect left ventricular dysfunction and also BNP levels contribute to the diagnosis of the type heart failure in essential hypertension patients.