摘要
目的探讨高血压合并阵发性心房纤颤(PAF)患者左心功能、心脏结构特点及与脑钠肽(BNP)、内皮素(ET)的关系。方法选取2015年1月~2016年1月于西安市第九医院确诊的高血压合并PAF组(即PAF组70例)、原发性高血压(即高血压组70例)、同时期健康体检者(即对照组70例),采用超声心动图检测三组左室射血分数(LVEF)、左房内径(LAD)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDd)、舒张末期室间隔厚度(IVSTd)、舒张末期左室后壁厚度(LVPWTd)、左室质量指数(LVMI)、每搏输出量(SV)、心输出量(CO),检测血清BNP和ET水平,分析其相关性。结果 PAF组的LAD、LVESD、LVEDd、IVSTd、LVPWTd、LVMI显著的高于高血压组、对照组(P<0.05),PAF组的LVEF显著的低于高血压组、对照组(P<0.05);高血压组的LAD、LVESD、IVSTd、LVPWTd、LVMI显著的高于对照组(P<0.05),高血压组的LVEF显著的低于对照组(P<0.05);三组研究对象的SV、CO水平差异无统计学意义(P>0.05);高血压伴PAF患者血浆BNP、ET水平与LAD、LVESD、LVEDd、IVSTd、LVPWTd、LVMI呈显著的正相关关系(P<0.05),与患者的LVEF呈显著的负相关关系(P<0.05),与SV、CO的相关性不显著(P>0.05)。结论高血压合并PAF患者的左心功能下降、发生较为明显的心肌重构,且与患者血浆BNP、ET关系密切。
Objective To investigate the characteristics of left ventricular function and structure, and relationship among them, B-type natriuretic peptide （BNP） and endothelin （ET） in patients with hypertension complicated by paroxysmal atrial fibrillation （PAF）. Methods The patients were chosen from the Ninth Hospital of Xi’an City from Jan. 2015 to Jan. 2016, and then divided into PAF group, essential hypertension group （EH group） and control group （each n=70）. The indexes of left ventricular ejection fraction （LVEF）, left atrial diameter （LAD）, left ventricular end-systolic diameter （LVESD）, left ventricular end-diastolic inner diameter （LVEDD）, interventricular septal thickness at end diastole （IVSTd）, left ventricular posterior wall thickness at end diastole （LVPWTd）, left ventricular mass index （LVMI）, stroke volume （SV） and cardiac output （CO） were detected by using echocardiogram in 3 groups. The level of serum BNP and ET were detected and correlation among characteristics of left ventricular function and structure, BNP and ET was analyzed. Results The indexes of LAD, LVESD, LVEDD, IVSTd, LVPWTd and LVMI were significantly higher （P〈0.05）, and LVEF was significantly lower （P〈0.05） in PAF group than those in EH group and control group. The indexes of LAD, LVESD, IVSTd, LVPETD and LVMI were significantly higher, and LVEF was significantly lower in EH group than those in control group （P〈0.05）. The difference in levels of SV and CO had no statistical significance among 3 groups （P〉0.05）. The levels of plasma BNP and ET were positively correlated to LAD, LVESD, LVEDD, IVSTd, LVPETd and LVMI （P〈0.05）, negatively correlated to LVEF （P〈0.05）, and had no significant correlation with SV and CO （P〉0.05）. Conclusion The patients with hypertension complicated by PAF have decreased heart function and significant myocardial remodeling, which is closely related to levels of plasma BNP and ET.
出处
《中国循证心血管医学杂志》
2017年第12期1522-1524,1527,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
高血压
阵发性房颤
左心功能
左心结构
B型钠尿肽
内皮素
Hypertension
Paroxysmal atrial fibrillation
Left ventricular function
Left cardiac structure
B-type natriuretic peptide
Endothelin
