B型利钠肽测定在急性胸痛鉴别诊断中的临床意义

目的探讨在急性胸痛患者中冠心病（CAD）患者与其他原因致胸痛患者中B型利钠肽（BNP）水平变化的临床意义。方法选择因急性胸痛入院患者161例,行冠脉造影进行鉴别诊断,明确冠心病83例（A组）,其中急性冠脉综合症（ACS）61例（A1组）,稳定性心绞痛22例（A2组）,冠脉造影正常组78例（B组）,测定不同组间BNP水平。结果冠心病组BNP浓度水平明显高于冠脉造影正常组,两者对比差异性显著（P〈0.01）,A1组与B组BNP浓度水平相比有显著性差异（P〈0.05）,A2组与B组BNP浓度水平相比差异无统计学意义（P〉0.05）,A1组与A2组BNP浓度水平相比有显著差异（P〈0.05）。结论BNP水平测定可作为胸痛鉴别诊断并对冠心病进行危险分层的常规生化指标。

The clinical significance in determination of plasma level of brain natriuretic peptide for differential diagnosis of acute chest pain

Objectives] To study the clinical significance of changes in plasma level of brain natriuretic peptide （BNP）, which was in patients with Acute chest pain, resulted from coronary artery disease （CAD） and other reasons. Methods] Select 161 patients in hospital with Acute chest pain, all of them with visualization in coronary artery. Identify that there were 83 cases in CAD （ Team A）, which include 61 cases in acute coronary syndrome （ACS） （Team A1） and 22 cases in stable angina pectoris （Team A2）, and 78 cases with normal visualization in coronary artery （Team B）. Determine plasma level of BNP in different teams. Results ] It was significant that the plasma level of BNP in team with CAD is higher than team with normal visualization in coronary artery （P 〈0.01）. Moreover, it was significant in comparison in plasma level of BNP, not only between team A2 and team B （P 〈0.05）, but also between team A2 and team A, （P〈0.05）. On the contrary, there was no significance of difference in plasma level of BNP between team A2 and team B （P 〉0.05）. Conclusion ] Determination of plasma level of BNP may be considered as a routine biochemical indicator, which may discriminate chest pain and classify the danger for CAD.