急性冠状动脉综合征患者N末端B型钠尿肽前体和肌钙蛋白Ⅰ水平与冠状动脉病变的关系

Correlation of NT-proBNP and cTnI with coronary lesion in patients with acute coronary syndrome

目的探讨急性冠状动脉综合征患者血清N末端B型钠尿肽前体(NT-proBNP)和肌钙蛋白I(cTnI)含量与冠状动脉病变程度的关系。方法选择急性冠状动脉综合征患者98例,分为急性ST段抬高心肌梗死(STEMI)组46例,急性非ST段抬高心肌梗死(NSTEMI)组16例,不稳定性心绞痛(UAP)组36例,均于入院时或发病24 h内测定患者血清NT-proBNP、cTnI含量,冠状动脉造影了解冠状动脉病变情况,并行心脏彩色多普勒超声检测,以评估患者的心功能。结果与UAP组比较,STEMI组和NSTEMI组NT-proBNP明显升高;与NSTEMI组比较,STEMI组cTnI明显升高(P<0.05)。NT-proBNP与冠状动脉病变积分呈正相关(r=0.156,P<0.05),与LVEF呈负相关(r=-0.196,P<0.01);cTnI与冠状动脉病变积分呈正相关(r=0.247,P<0.01)。结论急性冠状动脉综合征患者NT-proBNP与cTnI无关,但两者均可反映冠状动脉病变的严重程度。NT-proBNP的高低能反映患者的心功能状态,cTnI则与心功能无关。

Objective To study the correlation of NT-proBNP and cTnI with coronary lesion in pa- tients with acute coronary syndrome（ACS）. Methods Ninety-eight ACS patients were divided in- to acute ST segment elevation myocardial infarction（STEMI） group（n=46）,non ST elevation a- cute myocardial infarction（NSTEMI） group （n = 16）, and unstable angina pectoris （UAP） group （n= 36）. Their serum NT-proBNP and cTnI levels were measured and their coronary angiographic findings were observed at admission or within 24 hours after onset of ACS. Their cardiac function was assessed by cardiac color Doppler ultrasonography. Results The serum NT-proBNP level was significantly higher in STEMI group and NSTEMI group than in UAP group while the serum cTnI level was significantly higher in STEMI group than in NSTEMI group（P〈0.05）. The ser- um NT-proBNP and cTnI levels were positively correlated with the coronary lesion score （r = 0. 156,P〈0.05 ;r=0. 247, P〈0.01） and negatively correlated with the left ventricular ejection fraction（r=-0. 196,P〈0. 01）. Conclusion The serum NT-proBNP level is not correlated with the serum cTnI level in ACS patients. However, they can reflect the severity of coronary lesion. The serum N-proBNP level can reflect the cardiac function of ACS patients while the serum cTnI level cannot.