冠心病患者血浆BNP及hs-CRP水平变化与冠状动脉病变程度的关系研究

目的：观察不同类型的冠心病患者血浆B型利钠肽（BNP）、超敏C反应蛋白（hs-CRP）水平变化,并探讨与冠状动脉病变程度的相关性。方法：应用免疫荧光法和散射免疫比浊法对冠心病患者（110例）和正常对照组（36例）进行血浆BNP和hs-CRP水平检测。其中,冠心病患者根据临床症状分为急性心肌梗死（AMI组）48例,不稳定型心绞痛（UAP组）35例,稳定型心绞痛（SAP组）27例;根据冠脉造影分为单支（51例）、双支（34例）、多支（25例）病变组。结果：（1）AMI组平均BNP水平明显高于UAP组、SAP组和对照组（P〈0.01）,UAP组和SAP组BNP水平明显高于正常对照组（P〈0.01,P〈0.05）。多支病变组BNP高于单支、双支和正常对照组（P〈0.01）;（2）AMI组hs-CRP平均水平明显高于UAP组、SAP组和正常对照组（P〈0.01）,UAP组和SAP组hs-CRP水平明显高于正常对照组（均P〈0.01）。多支病变组hs-CRP高于单支、双支和正常对照组（P〈0.01）。结论：血浆BNP及hs-CRP水平在冠心病发生发展过程中起重要作用,并对冠心病的危险分层具有重要的临床意义。

Relationship between changes of plasma BNP,hs-CRP level and the severity of coronary lesions in patients with coronary heart disease

Objective：To investigate the relationship between plasma B-type natriuretic peptide（BNP）,high sensitive c-reactive protein（hs-CRP） level and the severity of coronary lesions in patients with a variety of coronary heart disease（CHD）.Methods：A total of 110 patients with CHD,including 48 cases of acute myocardial infarction（AMI）,35 cases of unstable angina pectoris（UAP） and 27 cases of stable angina pectoris（SAP）,and 36 normal subjects without CHD diagnosed by coronary angiography（CAG） served as the control group,were subjected to detect the plasma levels of BNP and hs-CRP.Among the 110 cases,the number of patients with single,double and three vessel lesion diagnosed by CAG were 51,34,25.Results：The plasma levels of BNP and hs-CRP in AMI,UAP,SAP,and the control group were different.Those in AMI group were higher than those in SAP group and UAP and control group（P0.01）.The plasma levels of BNP in UAP and SAP group were higher than those in control group（P0.01,P0.05,respectively）.The plasma levels of BNP and hs-CRP in single,double and three vessel lesion group were higher than those in control group（P0.01）.Conclusion：Assay for plasma levels of the BNP and hs-CRP in patients with coronary heart disease can carry helpful important information for acute coronary syndrome risk stratification.