B型钠尿肽、高敏C反应蛋白与急性心肌梗死患者心功能关系的临床研究

The relationship of BNP,hs-CRP with cardiac function in patients with acute myocardial infarction

目的分析探讨急性心肌梗死(AMI)患者B型钠尿肽(BNP)与血浆高敏C反应蛋白(hs-CRP)的变化及其临床意义。方法选择128例AMI患者为治疗组,并选择同期非急性心肌梗死患者120例作为对照组,采用免疫散射比浊法检测hs-CRP水平,同时以彩色多普勒检测并计算左室射血分数(LVEF)、左室后壁收缩期增厚率(△T%),并测定BNP水平。结果治疗组中BNP和血浆hs-CRP水平均明显高于对照组(P<0.05),并随心功能Killip分级的增加而升高,BNP与血浆hs-CRP水平和心功能Killip分级呈正相关(P<0.05)。AMI患者BNP和hs-CRP水平与左心室射血分数(LVEF)呈负相关(P<0.05),与左心室舒张末期内经(LVEDD)呈正相关(P<0.05)。结论 BNP与血浆hs-CRP水平与AMI预后显著相关,均是独立的不良预测因子,可以作为评价梗死后心功能状态和近期预后的敏感指标,亦可用于AMI的危险分层及判断预后。

Objective To investigate the plassma levels of brain natriuretic peptide （BNP） and high-sensitivity C-reactive protein （hs-CRP） in patients with acute myocardial infarction （AMI）, and estimate its value in the risk stratification. Methods The BNP and the serum levels of hs-CRP were detected in 128 cases with non-AMl and 120 cases with AMI. Left ventrlcular ejection fraction （LVEF） and left ventilator posterior wall thickness growing rate at systole （△T%） were measured by echocardiography. Results Compared with control group, AMI patients had high serum levels of hs-CRP. The higher the killip class was, the higher the levels of hs-CRP and BNP were. The concentration BNP and hs-CRP in AMI patients had a parallel rationship with LVEDD （P 〈 0.05）, but a nenative correlation with left ventricular ejection fraction （LVEF） （P 〈 0.05）. Conclusion The concentration of BNP and hs-CRP can help to evaluate the risk stratification and prognosis in patients with AMI.