摘要
目的检测急性蛛网膜下腔出血(SAH)患者血浆脑钠素(BNP)水平,超声心动图方法观察患者心脏左心室功能(LVF)的改变并探讨其机制,为防治急性SAH所致心脏损害提供依据。方法急性SAH组42例为发病24小时之内的急性SAH患者;高血压组30例,收缩压和舒张压均分别大于140mmHg与90mmHg,且除外心功能不全、心律失常等心脏并发症,无肝肾疾病史;正常对照组为来体检健康人;均行超声心动图检查,同时检测血浆BNP并对结果进行分析。结果急性SAH组患者的左室舒张末期内径、左室后壁厚度、室间隔厚度、相对室壁厚度、左室心肌重量、左室心肌重量指数均值与正常对照组比较差异无显著性。急性SAH组每搏输出量、每分心输出量及心脏指数均值低于正常对照组。急性SAH组左室射血分数均值明显低于正常对照组。急性SAH组E峰最大速度/A峰最大速度比值均值显著低于正常对照组。急性SAH组血浆BNP浓度高于正常对照组。结论急性SAH发病后血浆BNP浓度升高,并伴有左心室收缩功能和舒张功能下降;可能与急性SAH本身的病理生理机制有关。
Objective To observe the changes of left ventricular function in patients with subarachnoid hemorrhage （SAH） and the correlation with plasma brain natriuretic peptide （BNP） by using echocardiography and determining plasma BNP concentration, and to approach the mechanism and find the evidences for preventing and treating cardiac impairment caused by SAH. Methods 42 patients with SAH within 24 hours diagnosed by clinical manifestation and head computed tomography were selected. All enrolled patients had no history of heart diseases and no complications such as cardiac insufficiency and arrhythmia. And in the same period thirty sex and age matched hypertension patients and thirty sex and age matched healthy persons were enrolled as control groups. All patients and controls were undergone echocardiographic investigation and in the same time blood was drawn for the quantitative determination of plasma BNP concentration. Results There was no significant difference in the mean of end-diastolic left ventrieular internal dimension （LVIDd）, left ventricular end-diastolic posterior wall （LVPWT）, end-diastolic interventricular thickness （IVST） , relative wall thickness （RWT） ,left ventricular mass （ LVM ） , left ventricular mass index （LVMi） between SAH group and control group. The mean of stroke volume （SV） , the mean of cardiac output （CO） and the mean of cardiac index （CI） in SAH group were lower than those in control group respectively. The mean of LVEF in acute SAH group was much lower than that in control group. The mean of E/A ratio in acute SAH group was much lower than that in control group. The plasma BNP concentration in SAH group was higher than that in control group. Conclusion SAH can cause left ventricular systolic function to decrease and may eause left ventrieular diastolic function to decrease. The plasma BNP concentration increases after the onset of SAH. The rise of plasma BNP eoncentration may be caused by the pathophysiologie mechanism of SAH.
出处
《中国医刊》
CAS
2010年第7期35-37,共3页
Chinese Journal of Medicine
关键词
左心室功能
蛛网膜下腔出血
超声心动图
脑钠素
left ventricular function
subaraehnoid hemorrhage
echocardiography
brain natriuretie peptide
