急性心肌梗死患者血浆BNP、ANP、ET和CRP水平变化

为观察急性心肌梗死(AMI)患者血浆中脑钠肽(BNP)、内皮素(ET)、C-反应蛋白(CRP)和心钠素(ANP)水平变化, 探讨AMI发病机制,为诊断、治疗及预后判断提供依据, 应用酶联免疫及免疫放射分析法对46例AMI患者治疗前后和30名对照者血浆中的BNP、ET、CRP、ANP水平进行检测.结果显示, AMI患者血浆中BNP、ET、CRP、ANP治疗后均明显下降, 与治疗前比较有显著性差异(P＜0.01); AMI患者BNP、ET、CRP、ANP水平明显高于对照组(P＜0.01); BNP与CRP治疗前水平变化比较呈正相关r=0.847, 治疗后呈明显的下降趋势, 其相关系数为r=0.654; AMI患者治疗前后ANP与ET比较呈正相关, 但经溶栓和相应的支持治疗后ANP基本恢复到正常水平(P＞0.05),而BNP、ET、CRP水平虽然下降明显, 但与对照组比较仍有明显差异(P＜0.05).结论: AMI患者血浆中BNP、ANP、ET、CRP水平的变化说明其参与了急性心肌梗死发生、发展, 特别是冠状动脉粥样斑块的形成和(或)破裂及血栓形成, 其炎症因子是主要因素.因此, 四项指标的观察分析对AMI诊断、治疗、预后判断具有重要意义.

Changes of BNP, ANP, ET and CRP Levels in the Plasma of Patients with Acute Myocardial Infarction

To explore the pathogenesis and provide evidence for the diagnosis, therapy and prognosis of acute myocardial infarction (AMI) by observing the levels of brain natriuretic peptide(BNP), endothelins(ET), C-reactive protein(CRP) and atrial natriuretic peptide(ANP) in plasma of the patients, BNP, ET, CRP and ANP levels in plasma of 46 AMI patients before and after therapy and 30 normal controls were detected by ELISA and immunoradiometric assay, respectively.Results showed that there were significant differences in BNP, ET, CRP and ANP levels in patients with AMI before and after therapy( P <0.01), and the differences also existed in AMI group and normal controls( P <0.01).There was positive correlation between BNP and CRP before therapy( r =0.874) and after therapy( r =0.654), as well as ANP and ET before therapy. Though the ANP level returned to normal( P >0.05) after thrombolysis and other supporting therapy, the decreased BNP, ET and CRP were still significantly higher than those of control( P <0.05).The changes of BNP, ANP, ET and CRP indicate that they involved in the occurrence and development of AMI, especially in the formation and disruption of atheromatous plaquemay and thrombosis. So the detection of BNP, ANP, ET and CRP levels was significant to the diagnosis, therapy and prognosis judgement.