血浆氨基末端脑钠肽前体水平评价冠心病严重程度的价值

目的观察冠心病患者血浆氨基末端脑钠肽前体(NT-proBNP)水平变化,探讨血浆NT-proBNP水平评价冠心病严重程度价值。方法选择住院治疗,并行冠状动脉造影的患者205例,LVEF 75%共182例,分为急性心肌梗死(AMI)组(41例),不稳定性心绞痛(UAP)组(85例),稳定性心绞痛(SAP)组(40例)和正常组(16例);又根据冠状动脉造影分为单支病变组(52例)、双支病变组(49例)、多支病变组(64例)和零支病变组(40例)。采用Gensini积分法评价冠状动脉病变的狭窄严重程度,测定血浆NT-proBNP水平以及LVEF。结果AMI组和UAP组血浆NT-proBNP水平明显高于SAP组和正常组(P<0.05)。单支病变组、双支病变组和多支病变组血浆NT-proBNP水平明显高于零支病变组(P<0.05)。血浆NT-proBNP水平与LVEF呈负相关,与Gensini积分呈正相关。结论AMI和UAP患者血浆NT-proBNP水平明显升高,可能是冠心病危险分层的有效指标。

The value of NT-pro-brain natriuretic peptide in predicting the severity of coronary artery disease

Objective To explore the relation between plasma concentration of N-terminal-probrain natriuretic peptide(NT-proBNP) and severity of coronary artery disease(CAD).Methods 205 patients who complained of chest discomfort and had suspected CAD were enrolled in this study.According to diagnostic standard in 2007AHA/ACC guideline,the patients were divided into acute myocardial infarction group,unstable angina pectoris group,stable angina pectoris group and normal group.The plasma NT-proBNP concentration and LVEF were measured within 24 h after admission.All patients underwent coronary angiography and the severity of coronary artery lesions were determined by coronary angiographic Gensini scores.Results The NT-proBNP concentration in patients with acute coronary syndrome(including AMI,UAP) was much higher than that in patients with SAP and normal subjects(P<0.05).Patients with coronary lesions(including 1-vessel disease,2-vessels disease and multiple vessels disease) had higher levels of NT-proBNP compared with those without coronary lesions.The level of NT-proBNP positively correlated with Gensini score and negatively correlated with LVEF.Conclusion The NT-proBNP concentration progressively increases with the severity of CAD.The NT-proBNP concentration measured on admission will be a highly discerning tool for risk stratification.