急性冠状动脉综合征患者BNP水平及其影响因素分析

目的：探讨急性冠状动脉综合征（ACS）患者B型钠尿肽（BNP）的水平变化以及其影响因素。方法将2012-06-2013-01收治的100例冠心病患者根据临床表现和冠状动脉造影结果分为不稳定型心绞痛组（UA组）35例，ST段抬高心肌梗死组（STEMI组）20例及非ST段抬高心肌梗死组（NSTEMI组）45例，检测患者血液中BNP、C反应蛋白（CRP）水平，超声心动描记术评估左心室射血分数（LVEF），并计算冠状动脉狭窄程度（Gensini）积分，采用logistic回归法分析影响BNP水平的因素。结果 NSTEMI组的BNP、CRP及Gensini积分均高于UA组和STEMI组（均P＜0.05），UA组的BNP、CRP及Gensini积分均高于STEMI组（均P＜0.05）。NSTEMI组、UA组LVEF均低于STEMI组（均P＜0.05），NSTEMI组与UA组LVEF差异无统计学意义（P＞0.05）。在ACS患者中BNP＞250ng/L者心脏不良事件的发生率高于BNP≤250ng/L者（P＜0.05）。CRP、Gensini积分与BNP呈正相关，LVEF与BNP呈负相关（P＜0.05或0.01）。结论 ACS患者的BNP水平可在某种程度上反映冠状动脉病变程度，预测患者的预后，具有一定的临床价值。

BNP levels and its influencing factors in patients with acute coronary syndrome

Objective To investigate the B- type natriuretic peptide（BNP） level and its influence factors in patients with a-cute coronary syndrome（ACS）. Methods One hundred patients with coronary heart disease patients admitted from June 2012 to January 2013 were enrol ed in the study, including 20 cases of stable angina （STEMI）, 35 cases of unstable angina （UA） and 45 cases of non- ST- segment elevation myocardial infarction （NSTEMI）. The BNP, C- reactive protein （CRP） levels were tested, the left ventricular ejection fraction（LVEF） was examined and the extent of coronary stenosis（Gensini score） was calculated. The influ-ence factors of BNP level was analyzed with Logistic regression. Results The BNP and CRP and Gensini score in AMI group were higher than those in UA and STEMI groups （al P〈0.05）;those in UA group were higher than those in STEMI group （al P〈0.05）. LVEF in AMI, UA groups was lower than that in STEMI group（P〈0.05）, while there was no significant difference between A-MI and UA groups （P〉0.05）. The incidence of adverse cardiac events in patients with BNP 〉250ng/L was higher than that in those with BNP≤250 ng/L （P〈0.05）. Logistic regression analysis found that BNP was positively correlated with CRP and Gensini score, and negatively correlated with LVEF （P〈0.05 or 0.05）. Conclusion The levels of BNP can be used as an indicator for de-gree of coronary artery lesions and predict the disease outcome in patients with acute coronary artery syndrome.