【摘要】 目的探讨左室射血分数(LVEF)正常的高血压患者运动后N末端脑钠肽(NT-proBNP)水平的变化程度与左心室舒张功能障碍的相关性。方法试验组共50例高血压患者,左室射血分数≥50%;对照组为30名健康人。均测定静息状态下和运动平板试验后1 min时血清NT-proBNP水平,计算两者之间差值(ΔNT-proBNP)。两组均在静息状态下行经胸壁心脏超声检查。结果静息状态下两组间NT-proBNP水平差异无统计学意义;试验组中二尖瓣舒张早期最大血流速度(E)/心房收缩期最大血流速度(A)(E/A)<1亚组的患者与E/A≥1亚组比较,NT-proBNP水平差异无统计学意义。活动后对照组NT-proBNP水平虽有升高,但差异无统计学意义;试验组NT-proBNP水平差异有统计学意义(NT-proBNP 75.8 ng/L比45.2 ng/L,P<0.05)。试验组与对照组之间ΔNT-proBNP水平差异有统计学意义(ΔNT-proBNP 20.6 ng/L比11.1 ng/L,P<0.05)。试验组E/A<1亚组与E/A≥1亚组及对照组比较,ΔNT-proBNP差异有统计学意义(P<0.01)。结论LVEF正常的高血压患者其静息状态下NT-proBNP水平同健康人,活动后升高,尤其在E/A<1亚组中更加明显。更多还原

【Abstract】 Objective To investigate the relation of the post-exercise N-terminal pro brain natriuretic peptide(NT-proBNP) level to left ventricular diastolic dysfunction in hypertensive patients.Methods A total of 50 hypertensive patients with normal left ventricular systolic function and 30 healthy volunteers were enrolled.Echocardiography was performed in rest and E/A value was measured.Blood was drawn before and after maximal treadmill exercise and NT-proBNP levels were analyzed.Results Baseline NT-proBNP levels were not significantly different between hypertensive group and healthy control group.There was no difference in baseline NT-proBNP levels between the abnormal E/A and normal E/A subgroups in hypertensive group.In control group,there was no difference of NT-proBNP levels before and after exercise;while in the hypertensive group,NT-proBNP level was significantly increased after exercise compared to baseline level(75.8 ng /L vs.45.2 ng /L,P<0.05).The increase of NT-proBNP level post exercise(ΔNT-proBNP level) in hypertensive group was significantly higher than that in control group(20.6 ng/L vs.11.1 ng/L,P<0.05).In hypertensive group,NT-proBNP level was significantly higher in the abnormal E/A subgroup than in the normal E/A subgroup(42.7 ng/L vs.17.6 ng/L,P<0.01).Conclusion The NT-proBNP level significantly increases after exercise in hypertensive patients with abnormal E/A.NT-proBNP during exercise is a sensitive index for left ventricular diastolic dysfunction in patients with hypertension.更多还原