急性冠脉综合征测定血浆同型半胱氨酸和脑钠肽的意义

Significance of brain natriuretic peptide and homocysteine in patients with acute coronary syndrome

目的:探讨急性冠脉综合征(ACS)患者血浆脑钠肽(BNP)和同型半胱氨酸(Hcy)的变化及其临床意义。方法:测定以34例冠脉造影正常,心功能正常者作为对照。采用荧光免疫抗原抗体结合方法测定30例稳定型心绞痛(SAP)患者入院后第二天清晨及82例ACS患者症状发作后24h内的血浆BNP水平。采用高效液相色谱法测定所有患者入院第二日清晨血浆Hcy水平。结果:ACS患者血浆BNP浓度分别高于SAP组及对照组(P<0.01)。心肌梗塞(AMI)组BNP浓度高于不稳定型心绞痛(UAP)组(P<0.05)。ACS组的Hcy水平分别高于SAP组及对照组(P均<0.01)。结论:ACS患者血浆BNP和Hcy水平明显升高,AMI的较UAP的更高,提示两者在ACS的发病机制中起重要作用。

Objective： To explore the variation and significance of brain natriureuc peptide （BNP） and homocysteine （Hcy） in patients with acute coronary syndrome （ACS）. Methods： The study population consisted of 82 ACS patients, 30 patients with stable angina pectoris （SAP） and 34 healthy controls with normal coronary artery angiography （CAG）. Plasma BNP was measured by fluoroimmunoassay at 24 h in patients with ACS after the onset of ischemic symptoms. Hcy was measured using high performance liquid chromatography （HPLC） with fluorescence detection, ACS patients were divided into unstable angina pectoris （UAP） group and acute myocardial infarction （AMI） group. Results： The plasma BNP level in ACS group was significantly higher than that in SAP group and control group （P〈 0.01 all）. The level of BNP in AMI group was more than that of UAP group （P〈0.05）. The plasma Hcy level in ACS group was higher than that in SAP group and control group （P〈0.01 all）. Conclusion： Plasma BNP and Hey levels increase significantly in patients with ACS. It suggests that BNP and Hcy play an important role in the pathophysiology of ACS.