脑钠肽与冠脉造影病变关系的研究

Study on relationship between brain natriuretic peptide and coronary angiography

目的:观察血清脑钠肽(BNP)浓度的变化与冠脉病变之间的关系。方法:临床拟诊冠心病患者374例,按冠脉造影结果分为阳性组(235例)、阴性组(139例),并根据冠状动脉病变的范围分为单支血管病变组(64例)、双支血管病变组(79例)和三支血管病变组(92例),均于入院时测定血清中BNP、C反应蛋白(CRP)水平,进行统计分析。结果:阳性组BNP浓度为(115.91±53.64)pg/m l,阴性组(37.70±33.61)pg/m l,两组间差异有统计学意义,P<0.01;单支病变组浓度为(96.49±12.09)pg/m l、双支病变组浓度为(113.49±11.94)pg/m l、三支病变组浓度为(121.80±9.77)pg/m l,单因素方差分析示组间差异有统计学意义,P<0.05;多因素Logistic分析结果示BNP水平与冠脉造影(CAG)诊断冠心病(CHD)结果明显相关。结论:血清BNP水平是冠心病的独立危险因素,其水平的增高对冠心病患者病变累及的程度可能有一定临床参考价值,且BNP是较CRP更敏感的指标。

Objective： To investigate the relationship between the serum brain natriuretic peptide（BNP） concentration variances and coronary angiography disease.Methods： According to the results of coronary angiography,374 cases were divided into CHD group（235 cases） and the Non-CHD group（139 cases）.According to the scope of coronary artery disease,the CHD group were divided into single-vessel disease group（64 cases）,double-vessel disease group（79 cases） and three vessel disease group（92 cases）.All cases were respectively measured serum BNP and CRP levels on admission,then analyzed. Results： Levels of serum BNP of the CHD group（115.91 ± 53.64） pg/ml were significantly elevated compared with Non-CHD group（37.70±33.61） pg/ml,P〈0.01.Levels of serum BNP of the single-vessel disease group is（96.49±12.09） pg/ml,double-vessel disease group（113.49±11.94） pg/ml,three lesions（121.80±9.77） pg/ml.One-way ANOVA showed significant differences among groups,P〈0.05.Multinomial logistic analysis showed BNP levels significantly correlated CHD. Conclusion： Serum BNP level was an independent risk factor for coronary heart disease.Their levels increased in CHD patients may have some degree of clinical reference value for lesions involving the extent of coronary artery,and BNP was a more sensitive indicator than CRP.