CAJ | 학술논문

目的：研究老年无靶器官损害的高血压患者血浆N末端B型利钠肽原（NT-proBNP）水平与心室舒张功能减退的相关性。 　　方法：选取2012-03至2014-03我院收治的老年无靶器官损害的高血压患者66例，按照心室舒张功能不全诊断标准分为：研究组（n=27），均伴有舒张功能不全，将27例患者根据彩色多普勒超声心动图舒张功能分级分为：1级患者[舒张早期二尖瓣血流速度/舒张晚期二尖瓣血流速度（E/A）<1.0，舒张早期二尖瓣减速时间（DT）≥240 ms，等容舒张时间（IVRT）>90 ms]8例，2级患者（E/A>1.5，DT 150~220 ms，IVRT<90 ms）13例，3~4级患者（E/A>1.5， DT≤150 ms，IVRT<70 ms）6例；对照组（n=39），不伴有舒张功能不全。对比两组患者NT-proBNP及彩色多普勒超声诊断结果，分析NT-proBNP水平与各指标的相关性。 　　结果：研究组NT-proBNP水平显著高于对照组水平。舒张功能3~4级患者血浆NT-proBNP水平显著高于舒张功能2级患者和1级患者，舒张功能2级患者血浆NT-proBNP水平显著高于1级患者。Pearson相关分析显示，NT-proBNP水平与收缩压、舒张功能、E/E’呈正相关（r=0.211，P=0.037，r=0.442，P=0.004，r=0.556，P=0.000），而与E’/A’呈负相关（r=-0.372，P=0.000）。 　　结论：在老年无靶器官损害的高血压患者，血浆NT-proBNP水平升高则高度支持心室舒张功能减退，其水平与心室舒张功能有关。
목적：연구노년무파기관손해적고혈압환자혈장N말단B형리납태원（NT-proBNP）수평여심실서장공능감퇴적상관성。 　　방법：선취2012-03지2014-03아원수치적노년무파기관손해적고혈압환자66례，안조심실서장공능불전진단표준분위：연구조（n=27），균반유서장공능불전，장27례환자근거채색다보륵초성심동도서장공능분급분위：1급환자[서장조기이첨판혈류속도/서장만기이첨판혈류속도（E/A）<1.0，서장조기이첨판감속시간（DT）≥240 ms，등용서장시간（IVRT）>90 ms]8례，2급환자（E/A>1.5，DT 150~220 ms，IVRT<90 ms）13례，3~4급환자（E/A>1.5， DT≤150 ms，IVRT<70 ms）6례；대조조（n=39），불반유서장공능불전。대비량조환자NT-proBNP급채색다보륵초성진단결과，분석NT-proBNP수평여각지표적상관성。 　　결과：연구조NT-proBNP수평현저고우대조조수평。서장공능3~4급환자혈장NT-proBNP수평현저고우서장공능2급환자화1급환자，서장공능2급환자혈장NT-proBNP수평현저고우1급환자。Pearson상관분석현시，NT-proBNP수평여수축압、서장공능、E/E’정정상관（r=0.211，P=0.037，r=0.442，P=0.004，r=0.556，P=0.000），이여E’/A’정부상관（r=-0.372，P=0.000）。 　　결론：재노년무파기관손해적고혈압환자，혈장NT-proBNP수평승고칙고도지지심실서장공능감퇴，기수평여심실서장공능유관。
Objective: To study the relationship between plasma level of N-terminal B-type natriuretic peptide (NT-proBNP) and ventricular diastolic dysfunction in elder hypertensive patients without target organ damage. Methods: A total of 66 relevant patients treated in our hospital from 2012-03 to 2014-03 were studied. According to the standard of ventricular diastolic dysfunction, the patients were divided into 2 groups: Study group, n=27 patients with diastolic dysfunction and Control group, n=39 patients without diastolic dysfunction. The patients in Study group were further divided into 3 sub-groups based on Doppler classification of diastolic dysfunction:Grade 1, the patients with E/A<1.0, DT≥240 ms, IVRT>90 ms, n=8. Grade 2, the patients with E/A>1.5, DT (150-220) ms, IVRT<90 ms, n=13. Grade 3-4, the patients with E/A>1.5, DT≤150 ms, IVRT<70 ms, n=6. Plasma levels of NT-proBNP and Doppler ultrasound findings were compared to study the relationship between NT-proBNP and ventricular diastolic dysfunction. Results: Plasma level of NT-proBNP was higher in Study group than that in Control group. NT-proBNP level in Grade 3-4 sub-group was obviously higher than those in Grade 1 and Grade 2 sub-groups, NT-proBNP level in Grade 2 sub-group was higher than that in Grade 1 sub-group. Pearson correlation analysis indicated that NT-proBNP level was positively related to systolic blood pressure, diastolic function and E/E’ (r=0.211, P=0.037, r=0.442, P=0.004 and r=0.556, P=0.000), while negatively related to E’/A’ (r=-0.372, P=0.000). Conclusion: The increased plasma level of NT-proBNP are highly support for ventricular diastolic dysfunction in elder hypertensive patients without target organ damage, NT-proBNP level is related to ventricular diastolic function.