急性冠状动脉综合征病人治疗前后血浆脑钠肽N末端前体水平

目的观察急性冠状动脉综合征病人血浆脑钠肽N末端前体（N-terminal pro—brain natrluretic peptide，NT—proBNP）水平变化，评价该指标在急性冠状动脉综合征病人治疗中的临床意义。方法急性冠状动脉综合征病人60例（冠心病急性心肌梗死29例，不稳定型心绞痛31例），稳定性心绞痛33例，正常对照28例。采用电化学发光双抗体夹心免疫法分析检测血浆NT—proBNP水平，以超声心动图评价心功能．同时对急性心肌梗死25例经皮冠状动脉介入术前后上述指标进行分析。结果急性冠状动脉综合征组病人血浆NT-proBNP水平为3630ng／L（95％可信区间1412～9332），明显高于对照组75．8ng／L（95％可信区间40～144）（P〈0．001），而稳定性心绞痛组与对照组之间差异无统计学差异（P〉0．05）。且25例急性冠状动脉综合征病人在经皮冠状动脉介人术后12～24小时内血浆NT—proBNP水平从术前4732ng／L（95％可信区间为1828～12246）降至344ng／L（95％可信区间为192～616），差异有统计学意义（P〈0．01）。结论急性冠状动脉综合征病人血浆NT-proBNP含量明显升高，提示NT—proBNP可作为早期评估急性冠状动脉综合征病人的心功能情况。治疗后含量明显降低，可作为观察疗效的一个指标。

The clinical significance of plasma NT-proBNP changes in the patients with acute coronary syndromes

Objectives To observe the changes of plasma levels of NT-proBNP in patients with acute coronary syndromes(ACS), find out the clinical significance of NT-proBNP in the course of acute coronary syndrome therapy. Methods To use the nonextracted, enzyme-linked, sandwich immunoassay for measuring the plasma NT-proBNP concentration in patients with acute coronary syndrome included acute myocardial infarction (n=29) and unstable angina pectoris (n=31); stable angina pectoris (SAP) group (n=33); and control (n=28). The parameters of heart function were measured by echocardiography,and the levels of the substance of 25 ACS patients were measured again. Results Plasma NT-proBNP levels in the patients with ACS were significantly higher than those in the controls (P<0.001), but the level in SAP group and the controls were not significantly different in statistics (P >0.05). And the NT-proBNP level in the ACS patients decreased significantly after the PCI. Conclusions NT-proBNP levels in the patients with ACS increase significantly, and the result can evaluate the heart function in the acute coronary syndrome patients. The level can decrease significantly after the PCI therapy,so it can be a biochemical marker for the effect of the PCI.