CAJ | 학술논문

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 mmHg≤血压≤180／110 mmHg）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。
목적：탐토강압치료대노년고혈압반관상동맥협착환자혈장B형납뇨태（ BNP）수평적영향。방법선택관상동맥조영술결과시50％≤협착정도＜75％，차혈압공제미체표（140／90 mmHg≤혈압≤180／110 mmHg）적노년경、중도고혈압환자301례，근거관상동맥병변정도분위단지병변조118례、쌍지병변조104례、다지병변조79례。분별검측3조환자입원시급강압치료6개월적수축압、서장압、혈장BNP、좌실서장말기내경（ LVEDD）、좌방내경（ LAD）、좌실사혈분수（ LVEF）。결과강압치료6개월여입원시비교，단지、쌍지、다지병변조수축압、서장압균명현하강（P균＜0．05）；입원시수착관상동맥병변협착지수적증가，3조량량비교，환자혈장BNP수평승고；강압치료6개월，3조혈장BNP수평교각조입원시명현강저（ P균＜0．05）；입원시다지병변조교단、쌍지병변조，LAD、LVEDD승고，LVEF하강，강압치료6개월，다지병변조교치료전，LAD、LVEDD명현하강、LVEF명현승고（P균＜0．05）。결론강압치료가강저노년고혈압반관상동맥협착환자혈장BNP수평、개선심공능。
Objective To investigate the influence of antihypertensive therapy on the level of plasma brain B-natri-uretic peptide ( BNP) in the elderly hypertensive patients complicated with coronary artery stenosis.Methods A total of 301 mild to moderate elderly hypertensive patients with blood pressure≥140/90 mmHg and 50%≤degree of coronary ar-tery 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, plas-ma 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).Con-clusions The antihypertensive therapy can reduce the level of plasma BNP and improve heart function in elderly hyperten-sive patients complicated with coronary artery stenosis.