ACS患者B型钠尿肽和超敏C反应蛋白水平的变化及与冠状动脉病变程度关系

Study on the Levels of BNP and hs-CRP in ACS Patients and Their Relationships with the Extent of the Coronary Artery Lesion

目的探讨B型钠尿肽(B-type natriuretic peptide,BNP)和超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)在急性冠状动脉综合征(acute coronary syndromes,ACS)患者中的差异,同时观察二者与ACS患者冠状动脉病变严重程度的关系,探讨其临床意义。方法序贯入选住院并接受冠状动脉造影的ACS患者共105例,按临床诊断将ACS患者分为三组,再根据Gensini积分分为不同组别组进行比较分析。另设稳定性心绞痛(stable angina,SA)对照组和冠状动脉正常对照组。所有入选患者于入院即刻抽取静脉血进行BNP、hs-CRP测定。结果①ACS患者(包括不同临床类型亚组)在BNP和hs-CRP水平上均高于SA组及正常对照组,差异具有显著统计学意义(P<0.001)。②BNP和hs-CRP水平在不同冠状动脉病变程度ACS患者中存在统计学差异(P<0.001),且BNP和hs-CRP水平与反映冠状动脉病变程度的Gensini积分存在正相关:r=0.782(P<0.05);r=0.741(P<0.05)。结论 ACS患者的BNP和hs-CRP水平显著高于SA组及正常对照组且与冠状动脉病变的严重程度有关;BNP和hs-CRP可作为临床上评价入院ACS患者危险程度的简单、有效、实用的指标。

Objective To study the diversity of levels of B-type natriuretic peptide（BNP） and high sensitivity C-reactive protein（hs-CRP） in patients with acute coronary syndrome（ACS）,meanwhile,to investigate the relationships between the two biochemical markers and the extent of coronary artery lesions of ACS,and to assess the clinical value.Methods A total of 105 patients of ACS admitted were divided into three clinical types.These patients were also evaluated by Gensini score for a decision of coronary angiography（CAG） after admission,and divided into three sub-groups.Stable angina patients and normal volunteers were designated as control groups.The venous blood samples were taken from the patients immediately after admission for detection of BNP and hs-CRP.Results ①Significant differences in BNP and hs-CRP were found between ACS group including the different clinical subgroups and SA group/ normal group（P0.001）.②Significant differences in BNP and hs-CRP were found among three ACS sub-groups which were divided according to the severity of coronary artery disease in patients（P0.001）.There is a positive correlation between levels of BNP and hs-CRP and Gensini score in ACS patients.The corresponding Spearman correlation coefficients were： r=0.782（P0.05）,r=0.741（P0.05）.Conclusions The levels of BNP and hs-CRP in patients of ACS were much higher than those in SA group/ normal group.There is a correlation between levels of BNP and hs-CRP and different extent of coronary artery lesions in ACS patients.Combined detection of BNP and hs-CRP can be helpful and effective for risk stratification of the hospitalized patients with ACS after admission.