急性冠脉综合征患者血浆脑钠素检测及其意义

目的观察急性冠脉综合征(ACS)患者入院时血浆脑钠素(BNP)浓度,分析其与左室射血分数(LVEF)和心肌坏死标记物肌钙蛋白(IcTnI)的相关性,探讨其临床意义。方法73例急性冠脉综合征患者,按临床类型分为急性心肌梗死(AMI)组46例和不稳定性心绞痛(UA)组27例。同时从体检中心选择11例健康体检者作为健康对照组。ELISIA方法检测ACS患者血浆BNP和cTnI浓度,用超声心动图测定左室射血分数(LVEF),比较不同组别差异,并分析BNP与LVEF和cTnI的相关性。结果AMI组平均血浆BNP浓度明显高于UA组和正常对照组(P<0.01),UA组血浆BNP亦高于正常对照组(P<0.01)。AMI组BNP与LVEF呈负相关(r=-0.673,P<0.01),与cTnI呈正相关(r=0.398,P<0.05)。结论ACS患者入院时血浆BNP即明显升高,且各临床类型的血浆BNP水平存在差异,BNP水平不仅可以反映急性心梗患者心功能状态,而且也可以反映心肌坏死程度。

The value of brain natriuretic peptide in patients with acute coronary syndrome

Objective To investigate the level of plasma brain natriuretic peptide in patients with acute coronary syndrome(ACS) at admission. Analyze the relationship between BNP and cardiac troponin I (cTnI) and left ventricular ejection fraction (LVEF). Methods 73 patients with ACS were divided into acute myocardial infarction (AMI) and unstable angina(UA) groups.Centralized measurements of BNP were performed. Correlation between BNP and LVEF or cTnI was analyzed. Results The level of plasma BNP was significantly higher in AMI group than that in other groups (both P<0.01), the level of BNP in UA group was significantly higher than that in control group (P<0.01).BNP levels were negatively correlated with LVEF, while positively correlated with cTnI in AMI group. Conclusion Plasma BNP level increased significantly in ACS patients at admission. BNP may reflect both left ventricular dysfunction and the area of myocardial necrosis.