急性冠脉综合征与B型钠尿肽的临床相关性

目的检测急性冠脉综合征(ACS)患者血浆B型钠尿肽(BNP)水平,以探讨有关ACS的早期危险分层价值,分析BNP水平与病变严重程度、心功能评估、预后等相关性。方法选择ACS病例50例,分别在就诊后2 h内,抽取患者静脉血行BNP检测。就诊后,同时检测心电图、心肌酶、肌钙蛋白:3～5 d内,检查心脏彩超。观察患者住院期间有否出现心律失常、心源性休克、心衰、死亡等心血管不良事件发生。结果急性冠脉综合征患者血浆B型钠尿肽水平显著高于对照组血浆BNP水平,在ST段抬高的急性心肌梗死组明显高于非ST段抬高的ACS组。血浆BNP浓度与LVEF呈显著负相关。血浆BNP浓度、cTnI浓度、LVEF与ACS患者近期心脏不良事件明显相关。NYHA分级越高,B型钠尿肽水平越高。结论急性冠脉综合征时,血浆B型钠尿肽水平明显升高,与心力衰竭严重程度有关,且与预后密切相关。血浆BNP浓度,是ACS患者一个特异性较好的监测指标,是ACS患者早期危险分层的独立预测因子。

The Correlation between Acute Coronary Syndrome and B-type Natriuretic Peptide

Objective To detect plasma B-type natriuretic peptide（BNP） levels of acute coronary syndrome（ACS） patients in order to explore the early risk stratification of ACS,analysis the correlation between BNP levels and disease severity,cardiac function assessment,prognosis.Methods 50 cases of ACS patients were choiced.Their venous BNP levels within 2 hours after doctor visiting were detected,and ECG,cardiac CK-MB,troponin,echocardiography after visiting 3~5 days were also investigated at the same time.Any arrhythmia,cardiogenic shock,heart failure,death and other cardiovascular adverse events were recorded during hospitalization.Results Plasma BNP levels of ACS patients were significantly higher than control group and that in the ST-segment elevation acute myocardial infarction group were significantly higher than non-ST-segment elevation ACS group.Plasma BNP concentration was significantly negatively correlated with LVEF.Plasma BNP concentration,cTnI levels,LVEF have obviously correlation with the recent adverse cardiac events in ACS.The higher Killip grade,the higher BNP level.Conclusion Plasma B-type natriuretic peptide levels were significantly elevated in acute coronary syndrome,and it have correlation with the severity of heart failure and the prognosis.Plasma BNP concentration is a good specific monitoring indicators of,ACS and it might be an independent predictors in early risk stratification in ACS.