左室射血分数正常的老年高血压患者脑钠肽与左室肥厚和舒张功能不全的关系研究
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摘要
目的研究左室射血分数(LVEF)正常的老年高血压患者血浆脑钠肽(BNP)与左室肥厚(LVH)和左室舒张功能不全(LVDD)的相关性。方法选择我院收治的108例高血压患者,采用彩色多普勒超声心动图检测左室舒张末内径(LVEDd)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、LVEF、舒张早期血流播散速率(FPV)、左房室瓣舒张早期血液流速峰值(E)以及舒张晚期流速峰值(A),计算左心室重量(LVM)、左心室重量指数(LV-MI);对比分析两组间的各项检测指标,以及BNP水平与各项心脏超声指标的关系。结果 LVH组较正常组BNP水平及LVPWT均增加,E/A及FPV均降低,差异有统计学意义(P<0.01);LVDD组较正常组BNP水平、LVPWT和LV-MI均升高,E/A及FPV均降低,差异有统计学意义(P<0.01)。BNP与LVPWT和LVMI呈正相关(P<0.01),与E/A和FPV呈负相关(P<0.01)。结论高血压LVH时,BNP明显升高,而当高血压LVH伴LVDD时,BNP升高更明显,BNP是反映LVH及LVH伴早期LVDD的敏感指标。
Objective To study the correlation of plasma brain natriuretic peptide(BNP) levels with left ventricular hypertrophy(LVH) and left ventricular diastolic dysfunction(LVDD) in elderly hypertensive patients with left ventricular ejection fraction(LVEF).Methods 108 hypertensive patients were measured,left ventricular end-diastolic diameter(LVEDD),Interventricular septal thickness(IVST),left ventricular wall thickness(LVPWT),LVEF,flow propagation velocity(FPV),peak flow velocity of mitral early-diastolic(E)and late-diastolic peak flow velocity(A) were detected by color Doppler echocardjography.Left ventricular mass(LVM) and LVM index(LVMI) were calculated.The correlation of plasma BNP Ievels with cardiac ultrasonographic findings was also examined.Results LVH group compared with normal group,the plasma BNP and LVPWT were significantly increased,ratio of E/A and FPV were decreased,the difference was statistically significant(P<0.01);Compared with normal group,plasma BNP,LVPWT and LVMI in LVDD group were increased,the ratio of E/A and FPV were decreased,the difference was statistically significant(P<0.01).The BNP levels were positively correlated with LVMI and LVPWT(P<0.01),and were negatively correlated with E/A and FPV(P<0.01).Conclusion The BNP level is significantly higher in hypertensive LVH,especially when it is accompanied with LVDD,and is a sensitive indication for LVH accompanying early LVDD.
Objective To study the correlation of plasma brain natriuretic peptide(BNP) levels with left ventricular hypertrophy(LVH) and left ventricular diastolic dysfunction(LVDD) in elderly hypertensive patients with left ventricular ejection fraction(LVEF).Methods 108 hypertensive patients were measured,left ventricular end-diastolic diameter(LVEDD),Interventricular septal thickness(IVST),left ventricular wall thickness(LVPWT),LVEF,flow propagation velocity(FPV),peak flow velocity of mitral early-diastolic(E)and late-diastolic peak flow velocity(A) were detected by color Doppler echocardjography.Left ventricular mass(LVM) and LVM index(LVMI) were calculated.The correlation of plasma BNP Ievels with cardiac ultrasonographic findings was also examined.Results LVH group compared with normal group,the plasma BNP and LVPWT were significantly increased,ratio of E/A and FPV were decreased,the difference was statistically significant(P<0.01);Compared with normal group,plasma BNP,LVPWT and LVMI in LVDD group were increased,the ratio of E/A and FPV were decreased,the difference was statistically significant(P<0.01).The BNP levels were positively correlated with LVMI and LVPWT(P<0.01),and were negatively correlated with E/A and FPV(P<0.01).Conclusion The BNP level is significantly higher in hypertensive LVH,especially when it is accompanied with LVDD,and is a sensitive indication for LVH accompanying early LVDD.
引文
1 Lublen E,DeMaria A,Krishnaswamy P,et al.Utility of Brain natri-uretic peptide in detecting diastolic dysfunction;Comparison withDoppler velocity recordings[J].Circulation,2002,105:595-601.
2刘力生.高血压[M].北京:人民卫生出版社,2001:882-883.
3田玉龙,邢玉良,孙艳.脑钠肽及高敏C反应蛋白与慢性心力衰竭严重程度的关系[J].河北医药,2010,32:3146-3147.
4傅应裕,张松照,金亚平.脑钠肽在心血管疾病中的应用[J].国外医学临床生物化学与检验分册,2003,24(5):26-264.
5 Suzuki M,Yamamoto K,Watanabe S,et al.Association between ele-vated brain natriuretic peptide levels and development of left ventricularhypertrophy in patients with hypertension[J].Am J Med,2000,108(8):627.
6宝辉,苗懿德,刘颖,等.高龄老年高血压患者左室肥厚的相关因素研究[J].中国全科医学,2012,15(1):154.
2刘力生.高血压[M].北京:人民卫生出版社,2001:882-883.
3田玉龙,邢玉良,孙艳.脑钠肽及高敏C反应蛋白与慢性心力衰竭严重程度的关系[J].河北医药,2010,32:3146-3147.
4傅应裕,张松照,金亚平.脑钠肽在心血管疾病中的应用[J].国外医学临床生物化学与检验分册,2003,24(5):26-264.
5 Suzuki M,Yamamoto K,Watanabe S,et al.Association between ele-vated brain natriuretic peptide levels and development of left ventricularhypertrophy in patients with hypertension[J].Am J Med,2000,108(8):627.
6宝辉,苗懿德,刘颖,等.高龄老年高血压患者左室肥厚的相关因素研究[J].中国全科医学,2012,15(1):154.