冠心病及冠心病等危症患者血浆脂联素、氮端脑利钠肽前体的测定及相关性研究

目的探讨测定血浆脂联素（adiponectin，APN）与氮端脑利钠肽前体（N-terminal pro brain natriure ticpeptide，NT—proBNP）浓度在反映动脉粥样硬化范围和冠状动脉狭窄程度的临床意义。方法将符合人选标准的140例患者根据检查结果分为4组：冠状动脉性心脏病（冠心病）合并等危症组（39例）、单纯冠心病组（42例），冠心病等危症组（24例）以及对照组（35例）。采用定量的酶联免疫测定法（ELISA法）测定血浆APN浓度，采用Roche Elecsys1010自动分析仪测定血浆NT—proBNP浓度，所得结果进行统计学分析。结果冠心病等危症组、冠心病组和冠心病合并等危症组与对照组比较，血浆APN浓度依次逐步降低，差异有统计学意义（9．34±0．58）mg／L，（6．59±0．15）mg／L，（3．01±0．22）mg／L比（13．51±0．93）mg／L；F=3．625，P〈0．05）。冠心病等危症组、冠心病组和冠心病合并等危症组与对照组比较，血浆NT-proBNP浓度显著升高，差异有统计学意义（331．93±106．76）pg／mL，（320．82±78．85）pg／mL，（438．58±106．01）pg／mL比（65．60±12．03）pg／mL；F=74．082，P〈0．01）。直线相关分析显示，血浆APN浓度与血浆NT—proBNP浓度负相关（r一0．217，P=0．01）；Gensini积分与血浆APN浓度呈负相关（r=-0．522，P〈0．001），与血浆NT-proBNP浓度呈正相关（r=0．257，P=0．002）。结论同时测定血浆APN浓度和血浆NT—proBNP浓度有助于更好地预测动脉粥样硬化的范围和反映冠状动脉狭窄的程度。

Determination and correlation research of adiponectin and N-terminal pro brain natriuretic peptide in patients with coronary artery disease and its equivalents

ABSTRACT BACKGROUND The positive association of adiponectin(APN) with NT-proBNP has been discovered in patients with type 2 diabetes or chronic heart failure diseases.However whether this holds true in coronary artery disease(CAD) and it's equivalent patients remains unknown. MATERIALS AND METHODS Patients enrolled in the present study were classified into four groups: CAD witn equivalents group(n=39), CAD group (n=42), equivalents group(n=24) and age-matched healthy volunteers (n=35) as control. Plasma levels of APN and NT-pro BNP were measured. RESULTS APN levels decreased ordinally in the equivalent,CAD and CAD with equivalents groups as compared with the control group. There were significant differences compared within the four groups. There were higher NT-proBNP levels in CAD with equivalents,CAD and equivalent patients groups as compared with the control group. Plasma APN levels were negatively associated with plasma NT-proBNP levels(r=-0.217,p=0.01). severity of coronary artery stenosis was correlated with APN levels significantly and negatively(r=-0.522,p<0.0001) and correlated with NT-proBNP levels significantly and positively(r=0.257,p=0.002) in those combined four groups. CONCLUSION Plasma APN levels decreased significantly in the CAD with equivalents patients, and NT-proBNP levels increased in each kind of astherosclerosis.Maybe combined examination of APN and NT-proBNP levels can show severity of coronary artery stenosis more effectively and exactlly.