急性冠脉综合征患者血浆B型钠尿肽水平及影响因素分析

目的:分析急性冠脉综合征(ACS)患者血浆B型钠尿肽水平及影响因素和临床意义。方法:平行测定82例ACS,包括50例急性心肌梗死(AMI)、32例不稳定型心绞痛(UAP)患者、38例稳定型心绞痛(SAP)患者和30例非冠心病对照者的血浆BNP、血清肌钙蛋白I(cTnI)、左室射血分数(LVEF)、超敏C反应蛋白(hs-CRP)和白细胞(WBC)计数;分析ACS与另两组相关指标变化的差异及对BNP水平的影响。结果:AMI组和UAP组BNP水平分别为683.84士561.27pg/ml、386.05士201.54pg/ml,均明显高于对照组(55.67士35.46pg/ml),P均<0.01;AMI组BNP水平显著高于SAP组(201.21士105.0pg/ml,P<0.05)。直线相关分析显示ACS患者BNP水平升高与cT-nI、WBC、hs-CRP呈显著正相关(r分别为0.615、0.286、0.506,P均<0.05),与LVEF呈显著负相关(r=-0.714,P<0.01)。多元线性逐步回归分析发现cTnI、hs-CRP、LVEF与BNP独立相关(标准化偏回归系数β分别为0.391、0.240和-0.426,P<0.05)。结论:ACS患者血浆BNP水平升高可用于评价心肌缺血、坏死、炎症反应和心功能损伤程度。

The Analysis of the Clnical Significance of Plasma B-Type Natriuretic Peptide Levels in Patients with Acute Coronary Syndrome

Objective:To investigate the clinical significance of plasma B-type natriureticpeptide(BNP)levers in patients with acute coronary syndrome(ACS).Method:150 patients including 92 male and 58 female were divided into four groups:(1)Control group:30 controls with normal heartfunction without myocardiac ischemia and organic heart disease;(2)SAP group:38 patients of stable angina pectoris;(3)UAP group:32 patients of unstable angina pectoris;(4)AMI group:50 patients of acute myocardial infarction.The concentration of BNP was measured by Triage in the subjects.Results:The concentration of BNP in AMI group and UAP group(683.84士561.27pg/ml,386.05士201.54 pg/ml)were significantly higher than in control group(55.67士35.46pg/m1,all of P<0.01).The concentration of BNP in AMI group was significantly higher than in SAP group(201.21士105.06pg/ml,P<0.05).The level of BNP in AMI group were positively correlated with cTnI,WBC,hs-CRP(r=0.615,0.286 and 0.506,P<0.05)and was negatively correlation with LVEF(r=-0.714,P<0.01)in pearson correlation analysis;all of the cTnI,the hs-CRP and LVEF were independently correlated with BNP in multiple linear regression(β=0.391,0.240 and-0.426,respectively,P<0.05).Conclusion:The concentration of BNP is not only the sensitive index to evaluate the degrees of heart failure,but also maybe the potential index to judge the degree of myocardiac inflammation,ischemia and necrosis.