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目的比较高血压伴心力衰竭患者与单纯高血压患者血浆Apelin水平的差异。方法 120例原发性高血压患者,根据有无心力衰竭分为高血压伴心力衰竭组79例和单纯高血压组41例,采用双抗体夹心ELISA法测定血浆Apelin水平和脑钠肽(BNP)含量,采用飞利浦5700超声仪测左心室舒张期内径(LV)、左室射血分数(LVEF)和左室后壁(LVPW)。结果与单纯高血压患者相比,高血压伴心力衰竭患者血浆Apelin水平明显降低(P<0.05);多因素Binary Logistic回归分析显示,年龄、BNP、LV、LVEF和血浆Apelin水平与高血压患者心力衰竭的发生具有显著相关性(P均<0.05);心力衰竭患者晚期与早期比较,血浆Apelin水平明显降低(P<0.01);单纯高血压组中,血压分级越高,血浆Apelin水平越低(P<0.05)。结论血浆Apelin水平变化与高血压合并心力衰竭的发生和发展有一定关系,拟可将血浆Apelin水平作为高血压伴心力衰竭患者危险分层和临床转归的观察指标之一。
Objective To compare plasma Apelin levels between hypertensive patients with heart failure and those with simple hypertension. Methods A total of 120 patients with essential hypertension were divided into two groups according to the presence or absence of heart failure: 79 patients with hypertension and heart failure, and 41 patients with hypertension. Plasma levels of Apelin and BNP were measured by double antibody sandwich ELISA. The left ventricular diastolic diameter (LV), left ventricular ejection fraction (LVEF) and left ventricular posterior wall (LVPW) were measured by Philips 5700 ultrasound system. Results Plasma Apelin levels were significantly lower in hypertensive patients with heart failure than those in patients with hypertension alone (P <0.05). Multivariate Binary Logistic regression analysis showed that age, BNP, LV, LVEF and plasma Apelin levels were significantly associated with heart failure (P <0.05). The levels of plasma Apelin in patients with heart failure were significantly lower than those in patients with early heart failure (P <0.01). In hypertension group, the higher the blood pressure grade, the lower the plasma Apelin level P <0.05). Conclusion The change of plasma Apelin level is related to the occurrence and development of hypertension complicated with heart failure. It is proposed that plasma Apelin level can be used as one of the indicators of risk stratification and clinical outcome in patients with hypertension and heart failure.