血清B型利钠肽与肥厚型梗阻性心肌病临床特征的关系

Relationship between serum B-type natriuretic peptide and clinical features of hypertrophic obstructive cardiomyopathy

关键词:  血清B型利钠肽  肥厚型梗阻性心肌病  房颤

Key words:  serum B-type natriuretic peptide  hypertrophic obstructive cardiomyopathy  atrial fibrillation

摘要:

目的 探讨血清B型利钠肽（BNP）与肥厚型梗阻性心肌病（HOCM）患者临床特征之间的关系。方法 收集2010年1月至2016年1月HOCM 38例患者的临床资料，检测患者血清BNP水平，对BNP水平与患者的临床特征进行相关性分析。并进一步分为低水平BNP组（BNP<200 pg/mL）和高水平BNP组（BNP≥200 pg/mL），比较两组心电图，超声心动图，及心脏核磁等临床指标间的差异。结果 BNP水平与最大左心室壁厚（r=0.28，P=0.00）、室间隔厚度（r=0.31，P=0.00）、中隔E/Ea （r=0.51，P=0.00），横向E/Ea （r=0.41，P=0.00）呈显著正相关，与左室舒张末容积（LVEDD）及左室收缩末容积（LVESD）呈负相关（r=-0.39，P=0.00，r=-0.21，P=0.04）。在高水平BNP组中，心房颤动的发生率明显高于低水平BNP组（87.5%和65.0%，P=0.01）。结论 BNP水平与HOCM患者的临床特征密切相关，可反映左室的收缩/舒张功能。高水平的BNP与HOCM患者心房颤动的发生密切相关。

Abstract:

Objective To explore the relationship between serum B-type natriuretic peptide (BNP) and the clinical characteristics of hypertrophic obstructive cardiomyopathy (HOCM) patients. Methods The clinical data of 38 patients with HOCM, who were treated in the Department of Cardiac Surgery in the First Hospital of Lanzhou University from January 2010 to January 2016, were retrospectively analyzed. Patients' blood samples were collected to measure BNP level. The patients were divided into high level BNP group (BNP ≥ 200 pg/mL) and low level BNP group (BNP<200 pg/mL), and the clinical characteristics of electrocardiogram, echocardiography and cardiac magnetic resonance imaging were compared. Results BNP levels showed significantly positive relationship with maximal left ventricle wall thickness (r=0.28,P=0.00), ventricular septal thickness (r=0.31,P=0.00), septum E/Ea (r=0.51,P=0.00), and horizontal E/Ea (r=0.41,P=0.00) and negative relationship with LVEDD (r=-0.39, P=0.00) and LVESD (r=-0.21, P=0.04). In the high BNP level group, the presence of atrial fibrillation was significantly higher than that in the low BNP level group (87.5% and 65.0%, P=0.01). Conclusions BNP level is closely related to the clinical characteristics in patients with HOCM and can reflect the left ventricular systolic/diastolic function. High level BNP is closely related to the occurrence of atrial fibrillation.