急性心肌梗死患者氮末端脑钠素前体含量的变化

The change of plasma N-terminal pro-brain natriuretic peptide levels in patients with acute myocardial infarction

目的探讨氮末端脑钠素前体（NT-ProBNP）在急性心肌梗死、不稳定型心绞痛以及糖尿病中的意义。方法清晨空腹抽血．分离血浆，采用放射免疫分析分别检测急性心肌梗死32例；不稳定型心绞痛27例；2型糖尿病12例；对照组20例的NT-ProBNP含量。结果健康人血浆NT-ProBNP含量为（360．8±57．3）pg／ml，不同性别间无明显差异。急性心肌梗死和不稳定型心绞痛患者、2型糖尿病患者分别为（554．1±195．9）pg／ml和（525．7±199.1）pg／ml、（552．6±141．9）pg／ml．明显高于健康人（均P〈0．01），并且急性心肌梗死患者PTCA术后12h较术前明显升高（P〈0．05）。结论NT-ProBNP在急性心肌梗死、不稳定型心绞痛以及2型糖尿病患者血浆含量明显升高，可作为上述疾病重要诊断指标之一。

Objective To investigated the changes of plasma NT-proBNP levels in patients with acute my- ocardial infarction（AMI）, unstable angina pectoris （ UAP ） and non-insulin-dependent diabetes （ NIDD ）. Methods Plasma NT-proBNP levels were determined with RIA in 32 patients with AMI,27 patients with UAP, 12 patients with NIDD and 20 controls. Moreover, 16 of the 32 AMI patients underwent precutancous transluminal coronary angioplasty（PTCA） and plasma NT-proBNP levels were again determined 12h before and 12h after the procedure. Results The plasma NT-proBNP levels in controls were （360.8±57.3）pg/ml with no significant difference between the sexes. In patients with AMI, UAP and NIDD, NT-proBNP levels were （554.1±195.9） pg/ml, （525.7± 199.1 ）pg/ml and （552.6±141.9）pg/ml respectively;all of them were significantly higher than those in controls. AMI patients increased from （563.1±190.1 ）pg/ml to （774.7±238.9）pg/ml（ P〈0.05 ）. 12 hours after PTCA. However, NT-proBNP levels did not differ statistically among AMI, UAP and NIDD patients（ P 〉 0.05 ）. Conclusion The plasma NT-proBNP levels in patients with AMI, UAP and NIDD were increased significantly and the result suggested that NT-proBNP might beauseful risk marker for these diseases.