脑钠尿肽在预测2型糖尿病患者并发冠心病中的作用

目的探讨脑钠尿肽与2型糖尿病患者并发冠心病的关系。方法126例2型糖尿病患者入选,其中无冠心病的对照组(31例),并发冠心病者按临床类型分为稳定型心绞痛组(30例)、不稳定型心绞痛组(33例)和急性心肌梗死组(32例),所有患者检测脑钠尿肽浓度,同时检测并发冠心病各组的肌钙蛋白T,观察脑钠尿肽与肌钙蛋白T的相关性。结果心肌梗死组的脑钠尿肽水平明显高于其他三组(P<0.001),不稳定型心绞痛组脑钠尿肽高于稳定型心绞痛组及对照组(P<0.001),稳定型心绞痛组脑钠尿肽虽高于对照组,但无明显统计学意义(P>0.05);不稳定型心绞痛及心肌梗死组患者脑钠尿肽与肌钙蛋白T密切相关(r=0.948,P<0.001)。结论脑钠尿肽可预测2型糖尿病患者并发冠心病,并且其水平随冠心病的严重程度增加而升高。

The Level of Plasma Brain Natriuretic Peptide on Assessing Coexistent Coronary Heart Disease in Patients with Type 2 Diabetes

Aim To explore the relationship between plasma level of B-type natriuretic peptide(BNP) and coronary heart disease(CHD) in patients with type 2 diabetes.Methods 126 patients with type 2 diabetes were selected in this study.31 patients without CHD were as the control;clinical phenotypes of CHD were divided into 3 groups:acute myocardial infarction(AMI) group,32 patients;unstable angina pectoris(UAP) group,33 patients;and stable angina pectoris(SAP) group,30 patients.Plasma levels of BNP were detected on admission in 4 groups.Correlation between BNP and cardiac troponin T(cTnT) which was detected at the same time in SAP,UAP and AMI groups were observed.Results Plasma level of BNP were 41.8±7.5 ng/L,165.2±31.4 ng/L,509.5±125.6 ng/L and 24.1±3.7 ng/L in the patients with SAP,UAP,AMI and the control respectively.The level of BNP was significantly higher in AMI than that in other three groups(p<0.001);the level of BNP was significantly higher in UAP than that in SAP or control(p<0.001).BNP level were highly correlated with cTnT in UAP and AMI(r=0.948,p<0.001).Conclusion Plasma levels of BNP are associated with clinical phenotypes of coronary heart disease and it may reflect degree of myocardial necrosis in patients with type 2 diabetes.