B型钠尿肽与急性冠脉综合征主要中医证型的相关性研究

目的检测急性冠脉综合征(ACS)几种主要中医证型患者的血浆B型钠尿肽(BNP)水平并加以比较,分析BNP水平与病变分型的严重程度、心功能评估、预后等相关性。方法选择ACS 56例病例进行血浆BNP的检测,同时依照中医辨证对病例进行分型,选择心血瘀阻证、痰浊闭阻证、气阴两虚证、心肾阳虚证这几种证候类型作为对比。结果急性冠脉综合征患者血浆B型钠尿肽水平显著高于对照组血浆BNP水平,在ST段抬高的急性心肌梗死组明显高于非ST段抬高的ACS组,血浆BNP浓度与心功能明显相关。心肾阳虚证组BNP水平高于其他分组,心血瘀阻证与痰浊闭阻证组BNP水平高于气阴两虚证组。心血瘀阻证与痰浊闭阻证两组BNP水平无明显差异性。结论急性冠脉综合征心肾阳虚证血浆B型钠尿肽水平明显升高,与心功能分级严重程度有关,且与预后密切相关。血浆BNP浓度可以作为ACS患者辨证分型一个客观监测指标,为中医辨证论治提供依据。

The Relationship between B-style Natriuretic Peptide and the Main TCM Syndrome of Acute Coronary Syndrom

Objective Detection of acute coronary syndrome（ACS） several major traditional Chinese medicine syndromes in patients with plasma B-type natriuretic peptide（BNP） levels to be compared,analyzed BNP levels and severity of disease classification,cardiac function assessment,prognosis and other relevant.Methods Select ACS patients 56 cases of plasma BNP testing for the same time,in accordance with TCM classification of cases is,select Blood Stagnation card,phlegm closed resistance certificate,Qi and Yin Deficiency certificate,permit these types of heart deficiency syndrome type as a comparison.Results With acute coronary syndrome in patients with B-type natriuretic peptide level was significantly higher than plasma BNP levels,in the ST-segment elevation acute myocardial infarction group was significantly higher than that of non-ST-segment elevation ACS group,plasma BNP concentrations and cardiac function significant correlation.Heart deficiency syndrome group BNP levels higher than other groups,Blood Stagnation Syndrome and phlegm closed higher than the level of resistance syndrome group BNP Qi and Yin Deficiency Certification Section.Blood Stagnation Syndrome and phlegm obstructing closure permits the two groups no significant differences in BNP levels.Conclusion Acute coronary syndrome Heart Kidney-Yang Deficiency of plasma B-type natriuretic peptide levels were significantly elevated,and cardiac function related to the severity classification,and is closely related with the prognosis.Plasma BNP concentration in patients with ACS can be used as an objective monitoring syndrome type indicator,in order to provide a basis for Chinese medicine syndrome differentiation.