急性冠脉综合征患者血浆B型钠尿肽的变化及其临床意义

Plasma level of B-type natriuretic peptide in patients with acute coronary syndrome and its clinical significance

目的:观察急性冠脉综合征(ACS)患者不同情况下血浆B型钠尿肽(BNP)水平,探讨BNP在ACS发病过程中的意义。方法:用免疫荧光快速检测法检测35例ACS患者经皮冠脉介入治疗(PC I)术前、术后24 h血浆BNP水平,并与20例正常对照组血浆BNP水平进行对比。观察和分析ACS患者PC I前血浆BNP水平与心功能及冠状动脉评分(Gensin i积分)间的关系。结果:ACS患者入院时血浆BNP水平高于正常对照组(P<0.001),而介入治疗后BNP水平却明显下降(P=0.027);PC I术前、术后血浆BNP水平急性心肌梗死组均较不稳定心绞痛组高;血浆BNP水平,PC I前LVEF<50%的明显高于LVEF≥50%患者(P<0.001),且血浆BNP水平与LVEF呈高度负相关(r=-0.88,P<0.001),但与Gensin i积分无明显相关性(r=0.12,P>0.05)。结论:ACS患者血浆BNP水平明显增高,与患者心力衰竭严重程度相关,介入治疗可使ACS患者血浆BNP水平下降。

Objective To explore the significance of plasma B-type natriuretic peptide （BNP） level in patients with acute coronary syndrome（ACS）. Methods Thirty-five patients with ACS and twenty healthy controls were selected into this protocol. Blood samples of ACS patients were extracted from femoral vein on admission immediately and at 24 h after percutaneous coronary intervention （PCI）. The plasma BNP was measured by a bedside rapid assay. The plasma level of BNP was compared among those before and after PCI in ACS patients and healthy controls with different conditions of heart function. The relationship of BNP and Gensini scores was studied by correlation analysis. Results The plasma level of BNP was significantly increased in patients with ACS compared with that in the control subjects （P 〈 0. 001 ） , but BNP level was decreased after PCI （P = 0. 027）. Plasma BNP was significantly increased in ACS patients with a LVEF 〈 50% than in those with a LVEF≥50% （P 〈 0. 001 ）, and it was negatively correlated with LVEF （r = -0. 88, P 〈 0. 001 ） , but there was no significant relationship between Gensini scores and the plasma BNP in ACS group （r = 0.12, P 〉 0. 05 ）. Conclusion Plasma level of BNP increased significantly in ACS patients is correlated with classification of heart function, which can be decreased by percutaneous coronary intervention.