B型钠尿肽、高敏C反应蛋白与急性心肌梗死患者心功能关系的临床研究

目的分析探讨急性心肌梗死（AMI）患者B型钠尿肽（BNP）与血浆高敏C反应蛋白（hs—CRP）的变化及其临床意义。方法选择128例AMI患者为治疗组，并选择同期非急性心肌梗死患者120例作为对照组，采用免疫散射比浊法检测hs—CRP水平，同时以彩色多普勒检测并计算左室射血分数（LVEF）、左室后壁收缩期增厚率（△T％），并测定BNP水平。结果治疗组中BNP和血浆hs—CRP水平均明显高于对照组（P〈0．05）。并随心功能Killip分级的增加而升高，BNP与血浆hs—CRP水平和心功能Killip分级呈正相关（P〈0．05）。AMI患者BNP和hs—CRP水平与左心室射血分数（LVEF）呈负相关（P〈0．05），与左心室舒张末期内经（LVEDD）呈正相关（P〈0．05）。结论BNP与血浆hs—CRP水平与AMI预后显著相关，均是独立的不良预测因子，可以作为评价梗死后心功能状态和近期预后的敏感指标，亦可用于AMI的危险分层及判断预后。

The relationship of BNP,hs-CRP with cardiac function in patients with acute myocardial infarction

Objective To investigate the plassma levels of brain natriuretic peptide(BNP) and high-sensitivity C-reactive protein(hs-CRP) in patients with acute myocardial infarction(AMI),and estimate its value in the risk stratification.Methods The BNP and the serum levels of hs-CRP were detected in 128 cases with non-AMI and 120 cases with AMI.Left ventricular ejection fraction(LVEF) and left ventilator posterior wall thickness growing rate at systole(△T%) were measured by echocardiography.Results Compared with control group,AMI patients had high serum levels of hs-CRP.The higher the killip class was,the higher the levels of hs-CRP and BNP were.The concentration BNP and hs-CRP in AMI patients had a parallel rationship with LVEDD(P < 0.05),but a nenative correlation with left ventricular ejection fraction(LVEF)(P < 0.05).Conclusion The concentration of BNP and hs-CRP can help to evaluate the risk stratification and prognosis in patients with AMI.