脑钠肽与早发心绞痛患者近期预后的相关性

Plasma levels of B-type natriuretic peptide are associated with short-term survival in patients with premature anginal pectorsis

目的:探讨血浆脑钠肽(BNP)浓度对早发心绞痛患者近期心血管事件的预测价值。方法:检测110例早发心绞痛患者入院时的血浆BNP浓度,稳定型心绞痛(SAP)50例,不稳定型心绞痛(UAP)60例;26例健康体检者作为对照组。心绞痛患者按常规方法进行药物治疗和冠状动脉介入治疗,记录住院和随访平均6个月期间的心血管事件(心血管死亡、心力衰竭、再发心绞痛、心肌梗死);检测所有对象的BNP。结果:心绞痛组中UAP、SAP者与对照组血浆BNP浓度分别为(94.88±35.92)、(40.19±23.05)与(35.85±14.96)ng/L。UAP者平均BNP浓度高于SAP者和对照组(均P<0.01),SAP者与对照组BNP比较差异无统计学意义。UAP者心力衰竭、再发心绞痛、心肌梗死复合心血管事件发生率高于SAP者(20%∶6%,P<0.05)。SAP者、UAP者中发生心血管事件者BNP均高于未发生心血管事件者,分别为P<0.05、P<0.01。结论:血浆BNP浓度可以预测早发心绞痛患者近期心血管事件。

Objective：To explore the relationship between plasma levels of B-type natriuretic peptide（BNP） and short-term survival in patients with different types of premature anginal pectorsis（PAP）. Method： One hundred and ten patients with PAP, including 50 patients with stable anginal pectorsis（SAP） and 60 with unstable anginal pectorsis（UAP） were enrolled in this study and 26 healthy persons without coronary heart disease were grouped as controls. Plasma levels of BNP were detected on admission. Patients with PAP were treated with drugs conventionally and under went percutaneous coronary intervention, and then were followed up for average 6 months, the clinical cardiac events including cardiac death, heart failure, recurrent angina pectoris or MI were recorded. Influence of BNP on short-term cardiac events was analyzed. Result： The level of BNP was significantly higher in UAP （94.88±35.92） ng/L than that in SAP and controls （[40.19±23.05] ng/L and [35.85± 14.96]ng/L; P 〈0.01 and P 〈0. 01 respectively）. There were no significant difference of BNP level in SAP and controls （ P 〉0.05）. The complex cardiac events in UAP were more often than that in SAP （20% vs 6%, P 〈0.05）. Patients suffering from complex cardiac events in SAP had higher levels of BNP than those without （[52.30± 18.28] ng/L vs [38.67±24.5] ng/L, P 〈0.05）. Patients suffering from complex cardiac events in UAP had higher levels of BNP than those without （[124.13±26.63] ng/L vs [82.09±25.64] ng/L, P〈0. 01）. Conclusion：Plasma levels of BNP are associated with short-term survival in patients with PAP.