冠心病、高血压病患者血清中NT-proBNP等指标的调查与分析

An investigation about the levels of NT-proBNP,myocardial enzyme spectrum and Hs-CRP in the patients with hypertension and coronary heart disease

目的调查冠心病、高血压病患者血清中氨基末端脑钠素前体(NT-proBNP)、心肌酶谱、超敏CRP水平,探讨其临床意义。方法用日立7600全自动生化分析仪测定患者血清中心肌酶谱,在BN-Ⅱ特种蛋白分析仪上检测患者血清中超敏CRP,应用ANALYTICSE170光电免疫发光仪对血清NT-proBNP的含量进行测定。结果①两患者组血清中除AST(谷草转氨酶)水平无显著改变外(P>0.05),其它指标与对照组相比存在差异(P<0.01或P<0.05):两患者组NT-proBNP、LDH-L(乳酸脱氢酶)、超敏CRP水平均显著升高(P<0.01),CK-MB(肌酸肌酶同功酶)水平升高(均P<0.05);冠心病患者血清中CK(肌酸肌酶)、HBDH(α-羟丁酸)水平明显升高(P<0.01),高血压组血清中CK、HBDH水平有所上升(P<0.05)。②两患者组相比AST、CK-MB无显著性差异(P>0.05),冠心病组NT-proBNP、超敏CRP、LDH-L、CK、HBDH水平高于高血压病组(P<0.05)。结论两患者组心肌酶谱的大部分指标均在参考范围内,以心肌酶谱水平反映心肌损伤存在相当的局限性,血清中NT-proBNP、超敏CRP的联合检测可作为心肌酶谱检测的有力补充,可能对心肌损伤的分析判断更有意义。

Objective To investigate the levels of N-Terminal pro-brain natriuretie peptide （NT-proBNP）,myocardial enzyme spectrum and high-sensitivity C-reactive protein （Hs-CRP） in serum of the patients with hypertension and coronary heart disease, to probe the clinical meanings. Methods HITACHI 7600 blood biochemical analyzer was used to extract data of myocardial enzyme spectrum of the patients and normal controls, BN- Ⅱ Special Protein Analyzer was used to measure the level of the high-sensitivity C- reactiv protein（Hs-CRP） and the level of N-Terminal pro-brain natriuretie peptide （NT-proBNP） was measured by ANALYTICS El70 Immunity Analyzer. Results ①To compare with nonnals most of datas has changed except AST（ P 〈 0.01 or P 〈 0.05）. ②The levels of AST and CK-MB almost have no changed between two patient groups. In the patients with coronary heart disease the levels of NT-proBNP,Hs -CRP, LDH-L, CK, HBDH. Conclusion Most of datas of myocardial enzyme spectrum in the patients were in the normal refereneed ranges. It was difficult to evaluate heart funetion by the levels of myocardial enzyme spectrum. It is more effective to measure the levels of NT-proBNP and Hs -CRP to evaluate heart function.