高血压患者血浆脂联素和脑利钠肽与左心室肥厚的相关性研究

摘要

Objective To study the correlation of serum adiponectin (ANP) and brain natriuretic peptide (BNP) levels with left ventricular hypertrophy in essential hypertension patients,and to investigate its potential mechanism.Methods 80 patients with essential hypertension in our hospital were recruited.Secondary hypertension,cardiac,brain and renal insufficiency and diabetes mellitus were excluded in the study patients.Patients were divided into 2 groups:left ventricular hypertrophy group (LVH group,n=40) and hypertension group (hypertension patients without left ventricular hypertrophy,n=40).Age-,sex-,body mass matched health subjects were selected as control group (n =40).Serum levels of ANP and BNP were determined by enzyme-linked immunosorbent assay (ELISA).Left ventricular end diastolic dimension (LVEDD),left ventricular posterior wall thickness (LVPWT) and interventricular septum thickness (IVST) were detected by ultrasonic cardiography.Left ventricular mass (LVM) and left ventricular mass index (LVMI) were calculated according to formula of Devereux.Results There were significant differences in serum levels of APN and BNP and LVMI between hypertension,LVH and control groups [(7.9±0.3) mg/L,(6.7±0.1)mg/L vs.(12.0±0.2)mg/L,(116.1±16.1)μg/Lvs.(182.4±18.5)μg/L,(104.0± ±9.6)g/m2,(153.7±21.0)g/m2 vs.(83.1±9.1)g/m2,respectively,all P＜0.01].Serum APN level was negatively correlated with the severity of LVH (r=-0.789,P＜0.01),while serum BNP level was positively correlated with the severity of LVH (r=0.811,P＜ 0.05).Conclusions Serum APN and BNP levels have correlation with hypertension and hypertension related LVH.%目的 探讨高血压病患者血浆脂联素(APN)、脑钠肽(BNP)与左心室肥厚的关系及其形成的可能机理. 方法 泰州市人民医院心内科住院的患者120例,高血压80例,其中伴左心室肥厚者40例(左心室肥厚组),单纯高血压者40例(高血压组),另选40例年龄、性别、体质量与其匹配的健康者为对照组.入选患者均排除继发性高血压且无心、脑、肾功能障碍及糖尿病.酶联免疫吸附法(ELISA)法检测血浆APN和BNP水平.心脏超声检测患者左心室舒张末期内径(LVEDD)、舒张末期左心室后壁厚度(LVPWT)、舒张末期室间隔厚度(IVST).根据公式计算左心室质量(LVM)及左心室质量指数(LVMI). 结果 高血压组、左心室肥厚组APN、BNP、LVMI分别为(7.9±0.3)mg/L(116.1±16.1) μg/L、(104.0±9.6) g/m2与(6.7±0.1) mg/L、(182.4±18.5) μg/L、(153.7±21.0)g/m2,与对照组(12.0±0.2) mg/L、(69.1±8.9)μg/L、(83.1±9.1)g/m2比较,差异有统计学意义(均P＜0.01);左心室肥厚组与高血压组比较差异有统计学意义(均P＜0.01).血清APN水平与高血压左心室肥厚程度负相关(r=-o.789,P＜0.01),BNP水平与左心室肥厚程度正相关(r=0.811,P＜0.05). 结论 血清APN、BNP水平与高血压及高血压左心室肥厚有相关性.