血浆肌钙蛋白Ⅰ与脑钠肽浓度在心绞痛患者中的相关性研究

Correlation between plasma level of B-type natriuretic peptide and cardiac troponin I in patients with coronary disease

目的研究冠心病患者血浆脑钠肽(BNP)浓度的差异,急性冠脉综合征(ACS)患者血浆BNP浓度与肌钙蛋白I(cTnI)的相关性,并探讨BNP对ACS危险分层的价值。方法用酶联免疫吸附法(ELISA)检测了78例ACS患者、42例稳定型心绞痛(SAP)及30例非冠心病健康对照组的血浆cTnI、BNP水平,分析ACS组患者血浆BNP与cTnI的关系;随访120例冠心病患者60 d,观察终点为心肌梗死新发或再发、出现或心衰恶化和心源性猝死。结果血浆BNP在ACS组(138.10±4.85)pg/ml明显高于SAP组(30.62±1.08)pg/ml及对照组(29.27±1.45)pg/ml(P均<0.05)。SAP组和对照组BNP浓度差异无统计学意义(P>0.05)。ACS中cTnI阳性组血浆BNP浓度(152.21±1.86)pg/ml高于cTnI阴性组(78.10±1.85)pg/ml(P<0.01),血浆BNP浓度与cTnI浓度呈正相关(r=0.57,P<0.05)。120例冠心病患者中BNP>80 pg/ml组较BNP≤80 pg/ml组有更高的心肌梗死新发或再发率以及心衰发生或恶化率。结论 ACS组血浆BNP浓度升高,并与cTnI呈正相关;BNP对ACS患者近期预后有重要的临床价值,可作为危险分层的指标。

Objective To investigate the difference of plasma level of B-type natriuretie peptide （BNP） in patients with eoronary disease and correlation between BNP level and plasma cardiac troponin I （eTnI） in patients with acute coronary syndrome（ACS） and to explore the value of BNP in the risk stratification in acute coronary syndrome（ACS）. Methods The levels of plasma BNP and cTnI among 78 ACS patients,42 stable angina peetoris （SAP） and 30 without coronary heart disease（CHD） as control were measured by ELISA. The ACS patients were divided into eTnI positive group（48 patients） and eTnI negative group（30 patients）. Patients with ACS were followed up for 60 days. The end point was cardiac events including new or recurrent myocardial infraction, new or progressive congestive heart failure, and eardiae death. Results Plasma BNP levels were signifieandy higher in ACS group （ 138.10 ± 4. 85 ）pg/ml than SAP group （30. 62 ± 1.08 ）pg/ml and without CHD group （29. 27 ± 1.45 ）pg/ml （P 〈 0. 05）. There was no significant difference between without CHD group and SAP group in serum BNP levels （ P 〉 0. 05 ）. The level of BNP was significantly higher in ACS patients with cTnI （ ＋ ） group than that with eTnI （ - ） group （ P 〈 0. 05 ）. BNP level was positively correlated with eTnI in ACS patients （ r = 0. 57, P 〈 0. 05 ）. The plasma level of BNP 〉 80 pg/ml group was correlated with higher rates of new or recurrent MI and new or recurrent CH （ P 〈 0. 05 ） than that of BNP≤80 pg/ml group. Conclusion The level of BNP was significantly high and positively correlated with eTnI in ACS patients. BNP has practical signifieanee in evaluating the short-term out-come of ACS. It could be used as a marker for risk stratification of ACS.