杨志家^1,,
白彦芳²,
王绍伟^1,,,
张丽娜¹,
冯建海³
1. 邯郸市中心医院 心内三科, 河北 邯郸 056002
2. 冀中能源峰峰集团总医院ICU科, 河北 邯郸 056200
3. 武安市第一人民医院 心内科, 河北 武安 056300

基金项目: 河北省卫健委课题（20191481）


详细信息 作者简介: 杨志家(1982-), 男, 主治医师。E-mail:805520300@qq.com





通讯作者: 王绍伟, 副主任医师。E-mail:handan11201@163.com 中图分类号: R541.3


摘要:目的 分析原发性高血压3级伴不同类型左心室肥厚（LVH）患者血清硫脑苷脂水平及其与QT间期离散度和NT-proBNP等的相关性。方法 选取2018年11月至2019年11月于邯郸市中心医院心内科住院诊断为高血压3级并伴有左心室肥厚患者82例作为高血压LVH组，其中向心性重构亚组28例（男14例，女14例），向心性肥厚亚组28例（男13例，女15例）和离心性肥厚亚组26例（男15例，女11例）。选取同期于本院进行体检的健康体检者74例（男38例，女36例）作为正常对照组。所有入选对象均于清晨空腹状态下采取静脉血，检测血清硫脑苷脂和氨基末端脑钠肽前体（NT-proBNP）水平，行常规十二导联心电图检测，记录心电波形，获得心率矫正QT间期离散度（QTcd）。比较高血压LVH各亚组与正常对照组血清NT-proBNP、硫脑苷脂浓度及QTcd三项指标，采用多因素逐步回归方法对血清硫脑苷脂与QTcd、血清NT-proBNP等指标的相关性进行分析。结果 高血压LVH组血清硫脑苷脂浓度为（16.1±2.2）μmol/L，向心性重构、向心性肥厚、离心性肥厚3个亚组的血清硫脑苷脂浓度分别为（9.6±0.7）μmol/L、（14.7±1.8）μmol/L、（18.6±3.3）μmol/L，均显著高于对照组水平（6.0±1.2）μmol/L，P < 0.05。高血压LVH组及其亚组QT间期和NT-proBNP均高于对照组，差异均有统计学意义（P < 0.05）。血清硫脑苷脂与QTcd、NT-proBNP及SBP、DBP、TG、TC、LDL-C呈正相关。结论 测定硫脑苷脂水平升高有助于早期评价高血压引起的左室肥厚。
关键词: 高血压/
向心性重构/
向心性肥厚/
离心性肥厚/
硫脑苷脂


Abstract:Objective To analyze the relationship between serum sulfatide levels in patients with grade 3 essential hypertension and different types of left ventricular hypertrophy and their correlation with QT interval dispersion and NT-proBNP.Methods From November 2018 to November 2019, eighty-two essential hypertension patients who were diagnosed as grade 3 hypertension with left ventricular hypertrophy were selected as the hypertension LVH group, including 28 patients (14 males and 14 females) in the centripetal remodeling subgroup, 28 patients (13 males and 15 females) in the concentric hypertrophy subgroup and 26 patients (15 males and 11 females) in the centrifugal hypertrophy subgroup. A total of seventy-four health examinees (38 males and 36 females) during the same period were selected as the control group. All enrolled patients were taken venous blood in the early morning fasting state to measure the serum levels of sulfatide and NT-proBNP. Routine twelve-lead electrocardiogram tests were performed to record ECG waveforms and obtain QTcd of corrected QT interval dispersion of heart rate. The serum levels of NT-proBNP and sulfatide, as well as QTcd were compared between hypertensive LVH subgroups and normal controls. Correlation analysis and multi-factor stepwise regression method were used to analyze the correlation between serum sulfatide with QTcd and serum NT-proBNP.Results The serum levels of sulfatide were (16.1±2.2) μmol/L in the hypertension LVH group, and (9.6±0.7) μmol/L, (14.7±1.8) μmol/L and (18.6±3.3) μmol/L in the three subgroups of centripetal remodeling, concentric hypertrophy and centrifugal hypertrophy, respectively. The serum level of sulfatide in the hypertension LVH group was significantly higher than (6.0±1.2) μmol/L in the control group (P < 0.05). The QT interval and NT-proBNP in the hypertension LVH group and its subgroups were higher than those in the control group (P < 0.05). There was a positive correlation between serum sulfatide with QTcd, NT-proBNP and SBP, DBP, TG, TC, LDL-C.Conclusion The measurement of serum sulfatide is helpful for early assessment of left ventricular hypertrophy caused by hypertension.
Keywords:hypertension/
centripetal remodeling/
centripetal hypertrophy/
centrifugal hypertrophy/


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