大内皮素-1与肥厚型梗阻性心肌病患者心脏重构的相关性分析

发布时间：2018-03-09 20:39

  本文选题：心肌病　切入点：肥厚性　出处：《中国循环杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:探讨血浆大内皮素-1(Big ET-1)水平与肥厚型梗阻性心肌病(HOCM)患者心脏重构的相关性。方法:入选自2015-01至2016-05于我院住院治疗的HOCM患者167例,测定血浆Big ET-1、N末端B型利钠肽原(NT-pro BNP)水平等指标,完善心电图、动态心电图、超声心动图(UCG)及心脏磁共振成像(CMR)检查,进行相关统计学分析。结果:在167例HOCM患者中,相关性分析及多元线性回归发现Ln Big ET-1与Ln NT-pro BNP(r=0.35,P=0.000)、左心房前后径(r=0.169,P=0.019)及心率(r=0.141,P=0.037)呈正相关,与血红蛋白(r=-0.173,P=0.013)及室间隔厚度/左心室后壁厚度比值(r=-0.165,P=0.017)呈负相关。基于Big ET-1与左心房前后径呈正相关的发现,将研究对象分为左心房正常组74例及左心房增大组93例。与左心房正常组比,左心房增大组患者血浆Big ET-1水平显著增高(P=0.001);UCG测量的左心室舒张末期内径较大(P=0.024),室间隔较厚(P=0.003),左心室射血分数偏低(P=0.001);CMR测量的左心室舒张末期容积(P=0.002)及室间隔厚度(P=0.002)较大;伴发心房颤动的比率增加(P=0.004);存在二尖瓣中-大量反流(P=0.011)及纽约心脏协会(NYHA)心功能Ⅲ或Ⅳ级(P=0.022)的患者增多。结论:在HOCM患者中,Ln Big ET-1与Ln NT-pro BNP、左心房内径呈正相关。左心房增大的HOCM患者血浆Big ET-1水平显著升高,心脏结构重构更明显,伴发心房颤动的比率增加。Big ET-1可能在HOCM患者的心脏重构中发挥作用。
[Abstract]:Objective: to investigate the relationship between the level of plasma large endothelin-1 big ET-1 and cardiac remodeling in patients with hypertrophic obstructive cardiomyopathy (HCM). Methods: 167 HOCM patients who were hospitalized in our hospital from January 2015 to June 2005 were enrolled in this study. Plasma levels of plasma Big ET-1 N-terminal natriuretic peptide (NT-pro) were measured, electrocardiogram (ECG), dynamic electrocardiogram (ECG), echocardiography (UCG) and cardiac magnetic resonance imaging (Big) were examined. Correlation analysis and multivariate linear regression showed that there was a positive correlation between Ln Big ET-1 and Ln NT-pro BNPR 0.35, left atrium anterior and posterior diameter 0.169 Pu 0.019) and heart rate mensurus 0.141% P0. 037). There was a negative correlation between the ratio of interventricular septal thickness to left ventricular posterior wall thickness and the ratio of interventricular septal thickness to left ventricular posterior wall thickness, based on the positive correlation between Big ET-1 and the anterior and posterior diameter of left atrium. The subjects were divided into left atrial normal group (74 cases) and left atrial enlargement group (93 cases). The plasma Big ET-1 level in patients with left atrial enlargement was significantly higher than that in patients with left atrial enlargement. The left ventricular end-diastolic diameter was larger, the ventricular septum was thicker, the ventricular septum was thicker, the left ventricular ejection fraction was lower (P 0.001) and the left ventricular end-diastolic volume (P 0.002) and the interventricular septal thickness (P 0.002) were larger. The incidence of atrial fibrillation was increased in patients with moderate mitral mitral regurgitation (P0.011) and NYHA 鈪，

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