不同类型冠心病患者血清脑钠肽水平比较及其意义

A Study of the Relationship Between Plasma B-type Natriuretic Peptide Levels and Different Clinical Phenotypes of Coronary Heart Disease

目的:探讨不同类型冠心病患者血清脑钠肽(BNP)的差异并探讨其临床意义。方法:连续入选住院急性心肌梗死(AMI)患者25例、不稳定型心绞痛(UAP)患者30例、稳定型心绞痛(SAP)患者20例及对照组25例,测定BNP浓度,同时测定患者左心室射血分数(LVEF)、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)及肌钙蛋白T(TNT),并进行比较及相关分析。结果:AMI组BNP、CK、CK-MB、TNT结果与对照组比较差异有统计学意义(P<0.05);AMI组与UAP组BNP、CK、CK-MB、TNT结果比较差异有统计学意义(P<0.05);UAP组与SAP组及对照组BNP结果比较差异有统计学意义(P<0.05);AMI及UAP患者的BNP与CK、CK-MB、TNT之间有良好的正相关(P<0.05),与LVEF值呈负相关(P<0.05)。结论:不同类型冠心病患者血清BNP浓度存在差异,BNP可反映心肌坏死的程度并可作为预后监测及疗效观察的指标。

Objective： To explore the relation between plasma B--type natriuretic peptide levels and different clinical phenotypes of coronary heart disease. Methods： 100 samples were selected from October 2006 to October 2007 in the First Hospital Of Huairou . All of these patients fell into four groups, AMI group（25）, UAP group（30 ）, SAP group （20） and the control group（25）. All of these patients were regularly monitored with ECG and Ultrasonic cardiogram, and were given such laboratory exams as plasma BNP, LVEF, CK, CK--MB and TNT. Then an analysis of the correlation between BNP and LVEF, CK, CK--MB and TNT was made in every group. Results.. The levels of BNP, CK, CK-- MB, TNT were significantly higher in AMI group than those in other three groups（ P 〈0.05） ; BNP levels were positively correlated with TNT, CK,CK--MB and negatively correlated with LVEF in AMI group and UAP group. Conclusion.. There exists significant difference in plasma BNP levels among the patients with different kinds of coronary heart diseases. BNP may reflect the degree of myocardial necrosis and it has great value for the clinical evaluation of AMI.