脑钠肽与非ST段抬高的急性冠状动脉综合征严重程度及预后的关系

Correlation of natriuretic peptide level with severity and prognosis in patients with non-ST elevation acute coronary syndrome

目的探讨非ST段抬高的急性冠状动脉综合征（NSTEACS）患者血浆脑钠肽（BNP）浓度与疾病严重程度及预后的关系。方法NSTEACS患者132例，其中不稳定型心绞痛（UA）94例，非ST段抬高的心肌梗死（NSTEMI）38例，检测其血浆BNP、高敏C反应蛋白（CRP）和肌钙蛋白I（cTnI）浓度。对UA患者进行Braunwald分级，对NSTEMI进行Killip分级；1周内行冠状动脉造影，并随访6个月，根据随访期间不良事件的有无将患者分为不良事件和无不良事件组，比较2组BNP、CRP、cTnI水平。结果随着Braunwald和Killip分级增高，2组血浆BNP浓度均增高，且每两级间差异有统计学意义（均P〈0．05）；在不良事件组，血浆BNP、CRP、cTnI浓度均显著高于无不良事件组。结论NSTEACS患者血浆BNP浓度与疾病严重程度及不良预后相关。

Objective To explore the correlation of serum-B-type natriuretic peptide level（BNP） with the severity and the prognosis in patients with non-ST elevation acute coronary syndrome （ NSTEACS ）. Methods 132 patients with NSTEACS were chosen, including 94 with UA, 38 with NSTEMI. The patients with UA was separated by Braunwald classification and those with NSTEMI were separated by Killip classification when their venous blood were collected to measure and analyze the level of BNP, CRP and cTnI. Coronary angiographies were performed in a week. According to 6 months follow-up of adverse cardiac events, patients were divided into Group A （ with adverse cardiac events） and Group B （without adverse cardiac events）, and the BNP, CRP, cTnI level was compared, Resuits With the upgrading of Braunwald and Killip classification, the concentrations of BNP in both groups increased and there was significant difference between each two classes（ P 〈0.05 ）. Plasma concentrations of BNP, CRP, and cTnI in patients of Group B increased much more than those in patients of Group A. Conclusion Plasma concentration of BNP in patients with NSTEACS might be correlated with the degree of the disease and the adverse prognosis.