脑钠肽及超敏C反应蛋白水平与不同类型冠心病的关系

目的观察不同类型冠心病(CHD)患者的血浆N末端B型脑钠肽(NT-proBNP)及超敏C反应蛋白(hs-CRP)水平的变化,探讨其临床意义。方法 156例均经冠状动脉CT确诊的CHD患者,按临床类型分为:急性心肌梗死(AMI)组35例,不稳定型心绞痛(UAP)组63例,稳定型心绞痛(SAP)组58例;另选61例非CHD者作为对照组(CTR组)。分别采用免疫荧光法、透射比浊法检测住院患者及门诊患者血浆NT-proBNP及hs-CRP水平。结果AMI组、UAP组、SAP组和CTR组血浆NTproBNP水平分别为(1 903.99±2 055.21)、(897.27±947.34)、(677.98±718.12)、(129.39±126.49)ng/L;hs-CRP水平分别为(28.47±20.49)、(12.68±8.64)、(10.56±7.17)、(2.82±1.23)mg/L。AMI组血浆NT-proBNP及hs-CRP水平明显高于UAP组、SAP组和CTR组(P0.05)。UAP组血浆NT-proBNP及hs-CRP水平明显高于CTR组(P0.05),SAP组与CTR组各项指标水平比较差异无统计学意义(P0.05)。BNP与hs-CRP水平变化呈正相关。结论不同临床类型CHD患者的血浆NTproBNP及hs-CRP水平不同,提示上述指标对CHD患者进行危险分层及分析预后有一定临床价值。

Relationship of plasma levels of natriuretic peptide and high sensitivity C-reactive protein in the patients with different phenotypes of coronary heart desease

Objective To observed the changes of plasma levels of NT‐proBNP and hs‐CRP in patients with different types of coronary heart disease and investigate its clinical value .Methods 156 patients with CHD diagnosed by coronary computed tomo‐graphy angiography(CTA) were enrolled in this study ,including 35 cases of acute myocardial infarction(AMI) ,63 cases of unstable angina(UAP) and 58 cases of stable angina(SAP) .And 61 persons without CHD were selected as the control(CTR) .Plasma levels of NT‐proBNP and hs‐CRP were detected by the methods of immmunofluorescent antibody technic reader and turbidimetry ,respec‐tively .Results Plasma NT‐proBNP levels of AMI ,UAP ,SAP and CTR group were (1 903 .99 ± 2 055 .21) ,(897 .27 ± 947 .34) , (677 .98 ± 718 .12) ,(129 .39 ± 126 .49)ng/L ,respect ively .Plasma hs‐CRP levels were (28 .47 ± 20 .49) ,(12 .68 ± 8 .64) ,(10 .56 ± 7 .17) ,(2 .82 ± 1 .23)mg/L ,respectively .Plasma levels of NT‐proBNP and hs‐CRP in AMI group were obviously higher than those in UAP ,SAP and CTR group(P<0 .05) .Plasma levels of NT‐proBNP and hs‐CRP in UAP group were obviously higher than those in CTR group(P<0 .05) .There was no significant differences in these markers between SAP group and control group(P>0 .05) . Plasma BNP levels were positively correlated with plasma hs‐CRP .Conclusion Plasma levels of NT‐proBNP and hs‐CRP are asso‐ciated with different clinical phenotyes of CHD .Those markers may be helpful to the risk stratification and prognosis of CHD .