冠心病患者冠状动脉狭窄程度与循环B型利钠肽水平的关系

目的探讨冠心病患者冠状动脉狭窄与循环B型利钠肽(BNP)水平的相关性。方法选取冠心病患者85例作为冠心病组,同期无血管病变者46例作为对照组。采用Gensini评分系统评定冠状动脉狭窄程度,心脏超声测定左心室舒张未内径(LVDd)、左心室舒张末期容积(LVEDV)、LVEF、二尖瓣舒张早期运动速度(E)及舒张晚期运动速度(A),并计算E/A比值。用放射免疫法测定BNP浓度。结果冠心病组心功能(NYHA)Ⅲ级患者的E A值较Ⅰ、Ⅱ级降低,血清BNP水平较Ⅰ、Ⅱ级增加,血清BNP水平与E/A呈负相关(r=-0.61,P<0.05);冠心病组心功能Ⅲ级患者LVEDV、BNP水平较对照组显著升高(P<0.05),血清BNP与LVEDV呈正相关(r=0.65.P<0.05)。冠心病组LVEF较对照组明显减低(P<0.05),血清BNP较对照组升高(P<0.01)。Gensini积分与血清BNP水平呈正相关(r=0.851,P<0.01)。结论冠心痛患者血清BNP水平升高除与心功能不全相关外,心肌缺血亦可影响BNP分泌,导致循环BNP升高。

Correlation between coronary artery stenosis and B-type natriuretic peptide in patients with coronary heart disease

Objective To study the correlation between coronary artery stenosis and BNP in patients with CHD.Methods One hundred and one patients were divided into CHD group(n= 85) and control group(n= 46).Severity of coronary artery stenosis was assessed with the Gensini scoring system.Inner diameter of left ventricle at end diastolic phase,end left ventricular volume (LVEDV),early mitral diastolic peak velocity(E),atrial systolic peak velocity,late diastolic motion speed(A)were measured by echocardiography.E/A ratio was calculated.BNP level in CHD group was measured by RIA.Results The E/A ratio was significantly lower while the serum BNP level was significantly higher in CHD group than in control group(P<0.01) Indicating that the serum BNP level is negatively related with the E/A ratio(P<0.05).The serum LVEDV and BNP levels were significantly higher in CHD group than in control group,indicating that the BNP level is positively related with the LVEDV level(P<0.05).The serum LVEF level was significantly lower while the serum BNP level was significantly higher in CHD group than in control group(P<0.05).The Gensini score was positively related with the BNP level(P<0.01).Conclusion Increased serum BNP level in CHD patients is related with cardiac insufficiency.Myocardial ischemia can affect the secretion of BNP,thus leading to a high circulating BNP level.