急性冠状动脉综合征患者病变程度与NT-proBNP、H-FABP、hs-CRP的相关性研究

Study the levels of NT-proBNP、H-FABP and hs-CRP in ACS patients and their relationships with the extent of the acute coronary syndrome

目的探讨血浆N-末端B型脑钠肽(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、心脏型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)和超敏C反应蛋白(hs-CRP)在急性冠状动脉综合征(acutecoronary syndromes,ACS)患者中的变化,并探讨与冠状动脉病变严重程度的关系。方法入选住院并进行冠状动脉造影的ACS患者125例,依照临床诊断标准将ACS患者分为三组,再根据Gensini积分分组进行比较分析。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当天抽取静脉血进行NT-proBNP、H-FABP、hs-CRP测定。结果①ACS患者不同亚组在NT-pro BNP、H-FABP和hs-CRP水平上均高于SA组和正常对照组,统计学上具有统计学意义(P<0.05)。②NT-proBNP、H-FABP和hs-CRP水平在ACS患者不同冠状动脉病变程度组间存在统计学意义(P<0.05)。结论 ACS患者的NT-proBNP H-FABP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;NT-proBNP、H-FABP和hs-CRP可作为临床上评价入院ACS患者危险程度有效、实用的指标。

Objective To explore the diversity of levels of N-terminal pro-B-type natriuretic peptide （NT-proBNP）, heart type fatty acid-binging protein （H-FABP） and high sensitivity C-reactive protein （hs-CRP） in patients with acute coronary syndrome（ACS）, and to assess their clinical value. Methods A total of 125 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 NT-proBNP, H-FABP and hs-CRP. Results ①Significant differences in NT-proBNP,H-FABP and hs-CRP were found between ACS group including the different clinical subgroups and SA group/normal group （P 〈 0.05）. ②Significant differences in NT- proBNP,H-FABP and hs-CRP were found among three ACS sub-groups which were divided according to the severity of in patients with coronary artery disease （P 〈 0.05）. Conclusion There is a correlation between levels of NT-proBNP,H-FABP and hs-CRP and different extent of coronary artery lesions in ACS patients. Combined detection of NT-proBNP, H-FABP and hs-CRP can be helpful and effective for risk stratification of the hospitalized patients with ACS after admission.