【摘要】 目的探讨降压治疗对老年高血压伴冠状动脉狭窄患者血浆B型钠尿肽(BNP)水平的影响。方法选择冠状动脉造影术结果示50%≤狭窄程度<75%,且血压控制未达标(140/90 mm Hg≤血压≤180/110 mm Hg)的老年轻、中度高血压患者301例,根据冠状动脉病变程度分为单支病变组118例、双支病变组104例、多支病变组79例。分别检测3组患者入院时及降压治疗6个月的收缩压、舒张压、血浆BNP、左室舒张末期内径(LVEDD)、左房内径(LAD)、左室射血分数(LVEF)。结果降压治疗6个月与入院时比较,单支、双支、多支病变组收缩压、舒张压均明显下降(P均<0.05);入院时随着冠状动脉病变狭窄支数的增加,3组两两比较,患者血浆BNP水平升高;降压治疗6个月,3组血浆BNP水平较各组入院时明显降低(P均<0.05);入院时多支病变组较单、双支病变组,LAD、LVEDD升高,LVEF下降,降压治疗6个月,多支病变组较治疗前,LAD、LVEDD明显下降、LVEF明显升高(P均<0.05)。结论降压治疗可降低老年高血压伴冠状动脉狭窄患者血浆BNP水平、改善心功能。更多还原

【Abstract】 Objective To investigate the influence of antihypertensive therapy on the level of plasma brain B-natriuretic peptide( BNP) in the elderly hypertensive patients complicated with coronary artery stenosis. Methods A total of301 mild to moderate elderly hypertensive patients with blood pressure ≥140 /90 mm Hg and 50% ≤ degree of coronary artery stenosis < 75% were selected,and they would receive percutaneous coronary intervention( PCI). According to the degree of coronary artery stenosis,they were divided into the single-vessel disease group of 118 cases double-vessel disease group of 104 cases and multi-vessel disease group of 79 cases. The systolic blood pressure,diastolic blood pressure,plasma BNP,left ventricular end diastolic diameter( LVEDD),left atrial diameter( LAD) and left ventricular ejection fraction( LVEF) were compared before and 6 months after antihypertensive therapy. Results The levels of systolic blood pressure and diastolic blood pressure of the three groups were significantly decreased after antihypertensive therapy for 6 months,and the difference was statistically significant( all P < 0. 05). The level of BNP was significantly increased with the increasing number of coronary artery stenosis,the level of plasma BNP declined after antihypertensive therapy for 6 months in the three groups,and the difference was statistically significant( all P < 0. 05). The levels of LVEDD and LAD in the multi-vessel disease group were significantly increased and LVEF was decreased as compared with those of the single- and double-vessel disease groups; the levels of LVEDD and LAD of the multi-vessel disease group were significantly decreased and LVEF was increased after antihypertensive therapy for 6 months,and the difference was statistically significant( all P < 0. 05). Conclusions The antihypertensive therapy can reduce the level of plasma BNP and improve heart function in elderly hypertensive patients complicated with coronary artery stenosis.更多还原