急性冠状动脉综合征患者脑利钠肽水平与左心室射血分数的相关性研究

Relationship between brain natriuretic peptide and left ventricular ejection fraction in patients with acute coronary syndrome

目的观察急性冠状动脉综合征(ACS)患者临床特点,探讨血浆B型利钠肽(BNP)水平与左心室射血分数(LVEF)的关系。方法选取连续入院的124例ACS患者,记录其各项危险因素,测定血浆BNP水平和LVEF,分析男性(87例)与女性(37例)患者之间、ST段抬高型ACS患者(72例)与非ST段抬高型ACS患者(52例)之间以上指标的特点;探讨BNP水平与LVEF的相关性。结果 (1)与非ST段抬高型ACS组比较,ST段抬高型ACS组中有明确高血压病史者比例较高[69.4%(50/72)比46.1%(24/52)],BNP水平较高[(314.77±69.63)ng/L比(117.20±22.73)ng/L],而LVEF较低[(54.72%±11.71%)比(64.07%±11.18%)],差异均具有统计学意义(均为P<0.05);两组患者的性别构成比(男/女:33/19比54/18)、平均年龄[(63.1±9.5)岁比(66.0±11.7)岁]、糖尿病病史[16例(30.8%)比20例(27.8%)]、血脂异常病史[4例(7.7%)比13例(18.1%)]及吸烟史[30例(57.7%)比46例(63.9%)]差异均无统计学意义(均为P>0.05);(2)女性患者患病年龄晚于男性[(69.9±8.4)岁比(62.6±11.1)岁],具有高血压病史者女性多于男性[73.0%(27/37)比54.0%(47/87)],有吸烟史者女性少于男性[16.2%(6/37)比80.5%(70/87)],BNP水平女性高于男性[(402.84±89.22)ng/L比(159.22±30.57)ng/L],LVEF则女性低于男性[(57.07%±12.67%)比(62.35%±10.82%)],差异均具有统计学意义(均为P<0.05);两组间糖尿病患者比例[25.3%(22/87)比37.8%(14/37)]、高脂血症患者比例[17.2%(15/87)比5.4%(2/37)]及非ST段抬高型ACS患者比例[37.9%(33/87)比51.4%(19/37)],差异均无统计学意义(均为P>0.05);(3)ACS患者BNP与LVEF呈负相关(r=-0.349,P<0.05)。结论 ST段抬高型ACS患者较非ST段抬高型ACS患者高血压患病率高、BNP水平高而LVEF低;女性较男性ACS患者高血压患病率高,BNP水平高而LVEF低。BNP可作为早期评估ACS患者心功能水平的指标。

Objective To observe the characteristics of patients with acute coronary syndrome （ACS） and the relationship between brain natriuretic peptide （BNP） and left ventricular ejection fraction （LVEF）. Methods One hundred and twenty-four patients with ACS were enrolled in this study. Risk factors such as hypertension, diabetes mellitus and hyperlipdemia were recorded. Plasma BNP and LVEF were measured. The relationship between BNP and LVEF was analyzed. Results （1） Compared with non-ST elevation ACS, patients with ST-elevation ACS had more hypertension [69.4% （50/72） vs. 46. 1% （24/52）], higher BNP [（314.77 ±69.63） μg/L vs. （117.20±22.73） μg/L] and lower LVEF （54. 72% ± 11.71% vs. 64. 07% ± 11.18% ） （ all P 〈 0. 05 ）. （2） Compared with male patients, female patients were older [ （69.9 ± 8.4） years vs. （ 62. 6 ± 11.1 ） years ], more hypertension [ 73.0% （27/37） vs. 54.0% （47/87） ] and higher BNP [ （402. 84 ±89.22） μg/L vs. （ 159. 22 ± 30. 57） μg/L] lower proportion of smoking [ 16. 2% （6/37） vs. 80.5% （70/87）] and lower LVEF （57. 07% ±12.67% vs. 62.35% ±10.82%） （allP〈0.05）. （3） BNP was negatively correlated with LVEF in patients with ACS （P 〈 0. 05）. Conclusions BNP is good for early evaluation of heart function in patients with ACS.