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目的探讨高血压患者血清B型利钠肽(BNP)、高敏C反应蛋白(hs-CRP)水平与心房颤动之间的关系。方法对我院2007年10月至2009年2月连续收治的原发性高血压患者210例,根据超声心动图(UCG)测量左室舒张末内径(LVEDD)、室间隔厚度(IVSD)、左室后壁厚度(LVPWD)、左室射血分数(LVEF)、左房内径(LA),计算左室质量指数(LVMI)。根据ECG将患者分为房颤组(AF组,116例)及无房颤组(NAF组,104例),测定2组患者的血清BNP、hs-CRP水平。探讨高血压患者的血清BNP、hs-CRP水平其与房颤之间的关系。结果 AF组中阵发性房颤59例,持续性房颤24例,永久性房颤33例。AF组患者的BNP(198.66±118.84pg/mlvs.86.37±66.97pg/ml)与LVMI(127.19±28.05g/m2vs.83.70±17.22g/m2)明显高于NAF组(P<0.01)。永久性房颤患者BNP明显高于阵发性房颤患者(242.45±134.37pg/mlvs.178.95±102.72pg/ml,P<0.05),而阵发性房颤、持续性房颤患者BNP无显著性差异(P>0.05);3组间hs-CRP均无显著性差异(P>0.05)。高血压房颤患者BNP与患者LVMI、LA、房颤持续时间成正相关,与LVEF成负相关。Logistic回归分析表明,高血压患者血清BNP水平升高,房颤的可能性增大。hs-CRP与房颤之间无相关性(P>0.05)。结论 BNP与高血压房颤之间关系密切。BNP可作为高血压左心室心肌肥厚的标志物。
Objective To investigate the relationship between the levels of serum B-type natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP) and atrial fibrillation in patients with hypertension. Methods A total of 210 patients with essential hypertension were enrolled in our hospital from October 2007 to February 2009. The left ventricular end diastolic diameter (LVEDD), interventricular septum thickness (IVSD) Left ventricular wall thickness (LVPWD), left ventricular ejection fraction (LVEF) and left atrial appendage (LA) were calculated. Left ventricular mass index (LVMI) was calculated. Patients were divided into AF group (AF group, 116 cases) and non-AF group (104 cases) according to ECG. Serum BNP and hs-CRP levels were measured in two groups. To investigate the relationship between serum BNP, hs-CRP levels and atrial fibrillation in hypertensive patients. Results In AF group, 59 cases had paroxysmal atrial fibrillation, 24 cases had persistent atrial fibrillation, and 33 cases had permanent atrial fibrillation. BNP (198.66 ± 118.84pg / mlvs.86.37 ± 66.97pg / ml) and LVMI (127.19 ± 28.05g / m2vs.83.70 ± 17.22g / m2) in AF group were significantly higher than those in NAF group (P <0.01). The BNP level in patients with permanent AF was significantly higher than those in patients with paroxysmal atrial fibrillation (242.45 ± 134.37pg / ml vs.178.95 ± 102.72pg / ml, P <0.05), but there was no significant difference in patients with paroxysmal atrial fibrillation and persistent atrial fibrillation There was no significant difference in hs-CRP between the three groups (P> 0.05). BNP in patients with hypertension and atrial fibrillation patients with LVMI, LA, duration of atrial fibrillation is positively correlated with LVEF is negatively correlated. Logistic regression analysis showed that serum BNP levels in patients with hypertension increased, the possibility of atrial fibrillation increased. There was no correlation between hs-CRP and atrial fibrillation (P> 0.05). Conclusions There is a close relationship between BNP and hypertensive atrial fibrillation. BNP can be used as a marker of hypertensive left ventricular hypertrophy.