不同类型冠心病患者脑钠肽、和肽素及C反应蛋白的水平研究

目的：研究冠心病患者血清脑钠肽、和肽素及C反应蛋白（CRP）的水平与其病变类型和病变程度的关系。方法：选择100例冠心病患者，根据冠心病类型不同分为稳定型心绞痛（SAP）组、不稳定型心绞痛（UAP）组以及急性心肌梗死（AMI）组；选取同期接受体检的100例健康体检者作为对照组。对照研究四组血清脑钠肽、和肽素及CRP的水平。结果：冠心病3个类型分组的脑钠肽、和肽素、CRP水平以及Gensini积分均高于对照组，SAP组及UAP组的脑钠肽、和肽素、CRP水平以及Gensini积分均低于AMI组，差异均具有统计学意义（P〈0．05）；SAP组低于UAP组，差异具有统计学意义（P〈0．05）；1、2、3支病变冠心病患者的脑钠肽、和肽素、CRP水平以及Gensini积分均低于左主干病变患者，1、2支病变患者的脑钠肽、和肽素、CRP水平以及Gensini积分均低于3支病变患者，差异均具有统计学意义（P〈0．05）；而1支病变和2支病变患者之间比较，差异无统计学意义（P〉0．05）。结论：不同类型冠心病患者的脑钠肽、和肽素及C反应蛋白的水平存在显著差异，可以准确的反应其病变程度，具有重要的临床诊疗参考价值。

Brain natriuretic peptide,peptide and C-reactive protein levels in patients with different types of coronary heart disease

Objective： To study the correlation between brain natriuretic peptide, peptide as well as C-reactive protein （CRP） levels and types and severity of coronary heart disease. Methods. A total of 100 cases of coronary heart disease were divided into stable angina pectoris （SAP） group, unstable angina pec- toris （UAP） group and acute myocardial infarction （AMI） group; 100 healthy volunteers were also select- ed as control group. Levels of serum brain natriuretic peptide, peptide and CRP levels were detected and compared among the four groups. Results. Brain natriuretic peptide, peptide and CRP levels as well as Gensini score of the three different CHD groups were all higher than that of control group. Brain natriuret- ic peptide, peptide and CRP levels and Gensini score of both SAP group and UAP group were all significant lower than that of the AMI group （P〈0.05）. Between the latter two groups, SAP group showed lower levels than UAP group （P〈0.05）. Brain natriuretic peptide, and peptides factors , CRP levels and Gensini scores of patients with 1,2,3 -vessel coronary artery disease were lower than in patients with CHD involved left main coronary artery disease, levels and scores of patients with 1,2- vessel were lower than that in patients with 3-vessel disease, but between patients with 1- vessel disease and those with 2-vessel disease, there was no significant difference （P〉0.05）. Oonclusion： Brain natriuretic peptide, and peptides factors , CRP levels are significant different in patients with different types of CHD indicating they can re- flect severity of CHD and can be used as reference in clinical work.