2022 年第 2 期 第 17 卷

原发性高血压患者血浆N末端B型脑钠肽前体与左心室重构模式的关系

The relationship between plasma N-terminal pro-brain natriuretic peptide and left ventricular remodeling model in patients with essential hypertension

作者：唐婧1赵翎2阿曼古丽·如则2张峰波1

英文作者：Tang Jing1 Zhao Ling2 Amanguli Ruze2 Zhang Fengbo1

单位：1新疆医科大学第一附属医院医学检验中心，乌鲁木齐830054；2新疆医科大学省部共建中亚高发病成因与防治国家重点实验室，乌鲁木齐830054

英文单位：

关键词：原发性高血压；左心室重构；左心室质量指数；N末端B型脑钠肽前体

英文关键词：Essentialhypertension;Leftventricularremodeling;Leftventriclemassindex;N-terminalpro-brainnatriureticpeptide

• 摘要：

• 目的  分析原发性高血压患者血浆N末端B型脑钠肽前体（NT-proBNP）与左心室重构模式的关系。方法  选择2021年1月于新疆医科大学第一附属医院体检中心进行体检的健康对照者57例为正常对照组。纳入2021年1—3月新疆医科大学第一附属医院高血压科收治的原发性高血压患者175例，按照左心室构型分为正常构型组（NG组，59例）、向心性重构组（CR组，33例）、向心性肥厚组（CH组，29例）和离心性肥厚组（EH组，54例）。比较正常对照组与原发性高血压各组患者超声心动图参数和NT-proBNP水平，并分析NT-proBNP与各指标间的相关性。结果  CH组收缩压和舒张压、左心室质量指数（LVMI）和相对室壁厚度（RWT）均明显高于正常对照组、NG组和CR组(均P＜0.05)。EH组左心室舒张末期内径（LVEDD）和每搏输出量(SV)明显高于其他组(均P＜0.05)。CH组NT-proBNP明显高于正常对照组、NG组和CR组［（665±240）ng/L比（34±22）、（249±117）、（304±119）ng/L］(均P＜0.05)。NT-proBNP与收缩压（r=0.722，P＜0.001）、舒张压（r=0.722，P＜0.001）和脉压（r=0.393，P＜0.001）均呈正相关。NT-proBNP与LVMI（r=0.517，P＜0.001）、LVEDD（r=0.146，P=0.027）、RWT（r=0.408，P＜0.001）、SV（r=0.180，P=0.006）、心输出量（r=0.257，P＜0.001）均呈正相关，与二尖瓣血流舒张早期最大流速/二尖瓣血流心房收缩期最大流速比值（r=-0.388，P＜0.001）呈负相关。结论  原发性高血压患者中CH组的NT-proBNP值最高。NT-proBNP与未经治疗的原发性高血压患者的左心室重构模式有一定的相关性。

• Objective To analyze the relationship between plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and left ventricular remodeling model in patients with essential hypertension. Methods Totally 57 healthy volunteers who underwent physical examination in Physical Examination Center, the First Affiliated Hospital of Xinjiang Medical University in January 2021 were selected as the normal control group. From January to March 2021, 175 patients with essential hypertension treated in Department of Hypertension, the First Affiliated Hospital of Xinjiang Medical University were included. According to the left ventricular configuration, patients were divided into normal configuration group (NG group, 59 cases), centripetal remodeling group (CR group, 33 cases), centripetal hypertrophy group (CH group, 29 cases) and centrifugal hypertrophy group (EH group, 54 cases). Echocardiographic parameters and NT-proBNP levels were compared between normal control group and groups of essential hypertension, and the correlation between NT-proBNP and various indexes was analyzed. Results The systolic blood pressure, diastolic blood pressure, left ventricular mass index (LVMI) and relative wall thickness (RWT) in CH group were higher than those in normal control group, NG group and CR group (all P＜0.05). Left ventricular end diastolic diameter (LVEDD) and stroke volume (SV) in EH group were significantly higher than those in other groups (all P＜0.05). NT-proBNP level in CH group was significantly higher than that in normal control group, NG group and CR group［(665±240)ng/L vs (34±22), (249±117), (304±119)ng/L］(all P＜0.05). NT-proBNP was positively correlated with systolic blood pressure (r=0.722, P＜0.001), diastolic blood pressure (r=0.722, P＜0.001) and pulse pressure (r=0.393, P＜0.001). NT-proBNP was positively correlated with LVMI (r=0.517, P＜0.001), LVEDD (r=0.146, P=0.027), RWT (r=0.408, P＜0.001), SV (r=0.180, P=0.006) and cardiac output (r=0.257, P＜0.001), and was negatively correlated with maximum velocity of mitral valve in early diastole to maximum velocity of mitral valve in atrial systole  ratio (r=-0.388, P＜0.001). Conclusions The highest NT-proBNP level is observed in the CH group in patients with essential hypertension. NT-proBNP is associated with left ventricular remodeling model in untreated essential hypertension.