联合检测氨基末端脑钠肽前体和高敏C反应蛋白与冠脉病变程度的相关性研究

目的探讨急性冠脉综合征（ACS）患者冠状动脉粥样硬化程度和血浆氨基末端脑钠肽前体、高敏C反应蛋白水平之间的相关性。方法 ACS患者120例均行冠状动脉造影术,分为不稳定型心绞痛组（UAP组）40例,急性非ST段抬高性心肌梗死组（NSTEMI组）40例与急性ST段抬高性心肌梗死组（STEMI组）40例;同期正常体检者40名作为对照组。冠状动脉病变严重程度用病变血管支数及Gensini评分表示,于入院第2天抽血检测血浆氨基末端脑钠肽前体和高敏C反应蛋白水平,并进行比较。结果 ACS各组血浆氨基末端脑钠肽前体、高敏C反应蛋白水平和Gensini评分显著高于对照组（P〈0.01）,ACS各组氨基末端脑钠肽前体水平比较差异有统计学意义（P〈0.05）,Gensini评分各组比较差异无统计学意义;STEMI组高敏C反应蛋白水平高于NSTEMI组和UAP组（P〈0.01）;NSTEMI组与UAP组高敏C反应蛋白水平比较差异无统计学意义。血浆氨基末端脑钠肽前体、高敏C反应蛋白水平和Gensini评分随病变支数的增加而增加。结论联合检测氨基末端脑钠肽前体和高敏C反应蛋白水平可判断ACS的严重程度,对其诊治及指导早期行有创检查均有重要参考价值。

Correlation of Coronary Artery Stenosis with Plasma Levels of N-terminal Pro-BNP and High Sensitivec reactive protein

Objective To study the correlation of coronary artery stenosis with plasma levels of N-terminal pro-brain natriuretic peptide（NT-proBNP） and high-sensitive C-reactive protein（hs-CRP） in the patients（pts） with acute coronary syndromes（ACS）.Methods One hundred and twenty pts with ACS diagnosed by coronary arteriography were divided into three groups：Unstable angina pectoris（UAP） group（n=40）,non-ST-segment elevation myocardial infarction（NSTEMI） group（n=40）,and ST-segment elevation myocardial infarction（STEMI） group（n=40）.Forty normal subjects were selected as the control group.The severity of coronary artery lesions was evaluated by the number of diseased arteries and Gensine score.The levels of plasma NT-proBNP and hs-CRP were measured at admission and compared.Results The levels of plasma NT-proBNP,hs-CRP and Gensini score in ACS groups were significantly higher（P0.05）.The levels of plasma in each ACS group was different statistically（P0.05）.There was no difference in Gensini score（P0.05）.The hs-CRP level in STEMI group was higher than that in NSTEMI group and the UAP group（P0.01）.There were no significant difference of hs-CRP level in NSTEMI group and UAP group（P0.05）.The levels of plasma NT-proBNP,hs-CRP levels and Gensini score were increased with severity of coronary artery lesions.Conclusion The levels of plasma NT-proBNP and hs-CRP might determine the severity of acute coronary syndrome.