Objective To investigate the clinical values of NT-proBNP in left ventricular enlargement(LVE) and left ventricular dysfunction(LVD) of the patients with essential hypertension(EH) to provide a diagnostic basis for their diagnosis .Methods Plas-ma NT-proBNP concentrations in 120 patients with EH and in 29 normal controls were measured ,then the echocardiography exami-nation was performed to determine the left ventricular ejection fraction ( LVEF) ,left ventricular end-diastolic diameter(LVEDD) , left atrium(LA) and left ventricular systolic diameter(LVSDD) .The correlation between plasma NT-proBNP with LVE and LVD was analyzed .The diagnostic accuracy of NT-proBNP was analyzed by using receiver operating characteristic (ROC) curve .Results There were no statistically significant differences in the aspects of age ,sex and serum creatinine between the EH group and con-trol group ,but plasma NT-proBNP level of the former was significantly higher than that of the latter .The NT-proBNP level in the patients with LVE was significantly higher than that in the patients with normal left ventricle (P<0 .05) .The NT-proBNP level in the LVD patients was significantly higher than that in the patients with normal left ventricular function (P<0 .05) .The plasma NT-p roBNP level was positively correlated with LA ,LVEDD and LVSDD(r=0 .518 ,0 .58 ,0 .48 ,P<0 .01) while negatively crrelated with LVEF(r= -0 .61 ,P<0 .01) .The ROC curve showed that when the NT-proBNP was set at 380 pg/mL ,the sensitivity and specificity of NT-proBNP for diagnosing LVE were 80 .6% and 72 .4% ;which for diagnosing LVD were 80 .8% and 77 .4% ,re-spectively .Conclusion NT-proBNP is closely correlated with multiple ultrasonic indicators reflecting the left ventricular function and its level can reliably reflect the left ventricular contraction function ,which can serve as the marker for screening LVE and LVD in the patients with EH .%目的 研究血浆氨基末端脑钠素前体(NT-proBNP)在原发性高血压患者左心扩大和左心功能障碍中的临床价值,为高血压患者左心室扩大和心功能障碍诊断提供诊断依据.方法 将120例原发性高血压患者和29例健康者(对照组)纳入本研究.对上述人群进行以下的检测:测定血浆NT-proBNP浓度,用心脏彩色多普勒检查测定左室射血分数(LVEF)、左房内径(LA)、左室舒张末内径(LVEDD)、左室收缩末内径(LVSDD),分析血浆NT-proBNP与原发性高血压患者左心扩大和左心功能障碍的相关性,并用ROC曲线分析NT-proBNP的诊断准确性.结果 高血压患者与对照组在年龄、性别、血清肌酐(Scr)等方面比较差异无统计学意义(P>0.05),但前者的血浆NT-proBNP水平明显高于后者,而左心室扩大的患者血浆NT-proBNP水平明显高于左心室大小正常的患者(P<0.05);左心功能障碍患者血浆NT-proBNP水平明显高于左心功能正常患者(P<0.05).血浆NT-proBNP水平与患者LA、LVEDD、LVSDD呈正相关(r=0.518、0.580、0.480,P<0.01),与LVEF呈负相关(r=-0.61,P<0.01).ROC曲线显示,NT-proBNP的浓度设定在380 pg/mL,诊断左心室扩大的灵敏度为80.6%,特异度为72.4%.NT-proBNP的浓度设定在930 pg/mL,诊断左心室功能障碍的灵敏度为80.8%,特异度为77.4%.结论 NT-proBNP浓度与反映左心室功能的多个超声心动学指标紧密相关,其浓度能够较可靠地反映左心室的收缩功能,可作为筛查原发性高血压患者左心室扩大和左心功能障碍的标志物.
展开▼
