血氨基末端脑钠素前体与冠脉病变程度的关系

目的：探讨N末端脑钠肽前体（NT-proBNP）与冠心病患者冠状动脉病变程度的关系。方法：选择我科2010年1月～2012年6月住院治疗，疑冠心病行冠状动脉造影的患者206例，根据造影结果区分为单支病变组（54例）、双支病变组（52例）、多支病变组（67例），正常组（33例）；根据临床症状区分AMI组（45例），UAP组（91例），SAP组（43例），正常组（27例）；测定血浆NT-proBNP、肌酸激酶同工酶（CK—MB）和心肌肌钙蛋白I（cTnI）水平。采用Gensini积分法评价冠状动脉病变的狭窄严重程度。对各组数据进行统计学分析。结果：AMI组和UAP组血浆NT—proBNP水平显著高于SAP组和正常组（2．94±0．24）比（2．74±0．15）比（2．28±0．22）比（2．18±0．69），P〈0．01或〈0．053；单支病变组、双支病变组和多支病变组血浆NT—proBNP水平显著高于无病变组L（2．44±0．38）比（2．69土0．34）比（2．98±0．28）比（2．07±0．43），P〈0．05]。血浆NT-proB-NP水平与Gensini积分水平呈正相关（在单支、双支、多支病变组r分别为0．51，0．67，0．73，P均〈0．05）。结论：N末端脑钠肽前体浓度可作为预测冠状动脉病变程度的指标之一。

Relationship between plasma NT-proBNP and severity of coronary lesion in patients with coronary heart disease

Objective： To explore the relationship between plasma level of N terminal pro brain natriuretic peptide （NT-proBNP） and severity of coronary artery lesion in patients with coronary heart disease （CHD）. Methods： A to- al of 206 patients suspected CHD, who admitted from Jan 2010 to Jun 2012 in our department and underwent coro-nary angiography （CAG）, were divided into single vessel coronary disease group （n= 54）, double-vessel coronary disease group （n=52）, multi-vessel coronary disease group （n = 67） and normal group （n： 33）, according to CAG examination; and divided into acute myocardial infarction （AMI） group （n= 45）, unstable angina pectoris （UAP） group （n=91）, stable angina pectoris （SAP） group （n=43） and normal group （n=27） according to clinic symptom. All patients received measurement for NT-proBNP, creatine kinase-isoenzyme （CK-MB） and cardiac troponin I （cT- nI）. Stenotic severity of coronary artery lesion was evaluated using Gensini score method. Data of all groups were analyzed statistically. Results： Compared with SAP group and normal group, there was significant increase in plasma level of NT-proBNP （2.28±.22） vs. （2.18±0.69） vs. （2.94±0.24） vs. （2. 74±0.15）, P〈0.01 or P〈0.05] in AMI group and UAP group. Compared with normal group, there was significant increase in plasma level of NT-proBNP （2. 07±0.43） vs. （2.44±0.38） vs. （2. 69±0. 34） vs. （2. 98±0. 28）, P〈0. 05] in single, double and multi-vessel coronary disease groups. Plasma level of NT-proBNP was positively correlated with Gensini score （r= 0.51, 0.67, 0.73 respectively in single, double and multi-vessel coronary disease group, P〈0. 05 all）, Conclusion： NT-proBNP concentration can be regard as an index predicting severity of coronary artery lesion.