摘要
目的:比较研究老年高血压性肥厚型心肌病(HHCME)和高血压性左心室肥厚(HTN-LVH)患者的临床特点和血浆N末端B型利钠肽原(NT-proBNP)水平。方法:入选HHCME患者47例为HHCME组,HTN-LVH患者44例为HTN-LVH组。以二维及多普勒超声心动图分别测定两组患者左心房内径(LAd)、左心室舒张末期内径(LVEDd)、室间隔厚度(IVST),左心室射血分数(LVEF),舒张期二尖瓣口E波流速(VE)及A波流速(VA)等。用酶联免疫吸附法测定患者血浆NT-proBNP浓度。结果:①HHCME组患者与HTN-LVH组患者比较,左心室舒张末期内径明显缩小(P<0.001),室间隔厚度、左心室射血分数显著升高(P<0.001),两组VE/VA差异无统计学意义(P>0.05)。两组患者左心房内径差异无统计学意义(P>0.05);②NT-proBNP水平在HHCME组显著升高(P<0.01)。校正年龄、性别、高血压病史以及左心腔内经、室壁厚度及左心室收缩、舒张功能的影响后,HHCME组血浆NT-proBNP水平(1 317.19 fmol/ml)仍显著高于HTN-LVH组(526.19 fmol/ml),P<0.01。结论:HHCME患者血浆NT-proBNP水平明显高于HTN-LVH患者,预示HHCME患者预后较HTN-LVH患者差。血浆NT-proBNP水平可能有助于HHCME的鉴别诊断。
Objective： To compare the clinical characteristics and plasma level of N-terminal pro-brain natriuretic peptide （NT- proBNP） between the patients with hypertensive hypertrophic cardiomyopathy in elder age （HHCME） and the patients with hypertensive left ventricular hypertrophy （HTN-LVH）. Methods： Our work included 2 groups, HHCME group, n=47 and HTN-LVH group, n=44. Duplex Doppler echocardiography was performed to determine left atrial diameter （LAd）, left ventricular end-diastolic dimension （LVEDd）, interventricular septal thickness （IVST）, left ventricular ejection fraction （LVEF）, velocity of early diastolic period （VE） and velocity of end-diastolic period （VA） in mitral valve orifice. Plasma level of NT-proBNP was measured by ELISA. The above indexes were compared between 2 groups. Results： （1） Compared with HTN-LVH group, HHCME group presented decreased LVEDd and increased 1VST, LVEF, all P〈0.001. There were no significant differences in VE/VA ratio and LAd between 2 groups, all P〉0.05. （2） Plasma level of NT-proBNP was higher in HHCME group, P〈0.01. With the adjusted age, gender, history of hypertension, LAd, IVST, left ventricular systolic and diastolic function, the level of NT-proBNP in HHCME group （1317. 1 9 fmol/ml） was still significantly higher than that in HTN-LVH group （526.19fmol/ml）, P〈0.01. Conclusion： The plasma NT-proBNP level was higher in HHCME patients than that in HTN-LVH patients which indicated that HHCME patients may have worse prognosis. NT-proBNP might be helpful for differencing HHCME.
出处
《中国循环杂志》
CSCD
北大核心
2014年第6期432-435,共4页
Chinese Circulation Journal
基金
"重大新药创制"科技重大专项-<心血管创新药物临床研究科技术平台建设>(2012ZX09303-008-001)
关键词
老年性
高血压
肥厚型心肌病
左心室肥厚
N末端B型利钠肽原
Elder age
Hypertension
Hypertrophic Cardiomyopathy
Left ventricular hypertrophy
N-terminal pro-brain natriuretic peptide
