摘要
目的研究B型钠尿肽(BNP)与高血压左心室肥厚(LVH)以及LVH时无症状的左心室舒张性心功能不全(LVDD)的关系,探讨高血压LVH伴LVDD时的诊断方法。方法 113例高血压患者采用彩色多普勒超声心动图检测舒张末左心室室间隔厚度(IVSD)、左心室后壁厚度(PWT)、二尖瓣舒张早期最大峰值速度(E)、舒张晚期最大峰值速度(A)、E/A、左心室等容舒张时间(IVRT)等,计算左心室重量(LVM)、左心室重量指数(LVMI);采用酶联免疫法检测BNP,BNP与高血压LVH及LVDD的关系采用相关性分析。结果所有患者BNP与收缩压呈正相关(r=0.190,P<0.05),与IVSD、PWT、LVM、LVMI呈正相关(r=0.399、0.394、0.678、0.795、P<0.01);与E、E/A呈负相关(r=-0.885、-0.869,P<0.01);与A、IVRT呈正相关(r=0.735、0.817,P<0.01)。BNP在82.79ng/L时,诊断LVDD的敏感性为90%,特异性为100%,准确性为92%。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 find the sensitive and reliable diagnostic method for hypertensive left ven- tricular hypertrophy（LVH）accompanying left ventricular diastolic dysfunction（LVDD） by stud- ying the correlation between BNP and hypertensive LVH in hypertensive patients with LVH. Methods Blood pressure and heart rate of 113 hypertensive patients were measured. Interven- tricular septal defect（IVSD）,posterior wall thickness（PWT） of left ventricle at the end-diastolic phase,peak velocity of mitral valve at the early-diastolic phase（E） and peak velocity of mitral valve at the late-diastolic phase（A）, E/A, effusion deceleration time at the early-diastolic phase and isovolumetric relaxation time（IVRT）of left ventricle were detected by color Doppler echocar- diography. Left ventricular mass （LVM） and LVM index（LVMI） were calculated. Plasma BNP level was measured by ELISA and relation of BNP with hypertensiive LVH and LVDD was ana- lyzed. Results The BNP level was positively related with the SBP,IVSD,PWT,LVM,LVMI（r： 0. 190,0. 399,0. 394,0. 678,0. 795,P^0.05,P^0.01）,A and IVRT（r=0. 735,0. 817,P^0.01） while negatively related with the E and E/A（r----0. 885,--0. 869 ,P%0.01） in the 113 hyperten- sive patients. The BNP level could be used as a diagnostic criterion for LVDD with a sensitivity of 90%,a specificity of 100~ and an accuracy of 920//00 when it was 82.79 ng/L. Conclusion The BNP level is significantly higher in hypertensive LVH, especially when it is accompanied with LVDD,and is, thus, a sensitive indication for LVH accompanying early LVDD.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第7期694-697,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
高血压
肥大
左心室
利钠肽
脑
超声心动描记术
多普勒
彩色
心室功能障碍
左
hypertension
hypertrophy, left ventricular
natriuretic peptide, brain
echocardio- graphy, Doppler, color
ventricular dysfunction, left
