脑钠肽对左室收缩功能正常的冠心病患者冠脉病变严重程度的预测价值

The predictive value of brain natriuretic peptide for severity of coronary arterial lesion in patients with coronary heart disease and normal left ventricular systolic function

目的:探讨对左室收缩功能正常的冠心病(CHD)患者,血浆脑钠肽(BNP)水平能否预测冠状动脉病变的严重程度。方法:分析188例非ST段抬高型急性冠脉综合征及稳定型心绞痛患者的冠脉造影检查结果及入院24h以内的血浆BNP浓度,并根据冠脉病变的特征行Gensini评分,随后对二者进行相关分析。结果:双支病变及3支病变组患者BNP水平明显高于单支病变组及左主干病变组(276.2±193.7pg/mL,487.6±312.3pg/mL vs 105.5±41.5pg/mL,102.5±32.3pg/mL,均P<0.05),且3支血管病变组BNP水平较双支病变组升高(487.6±312.3pg/mLvs276.2±193.7pg/mL,P<0.05),单支病变组与左主干病变组间差异无统计学意义(P>0.05)。Spearman相关分析,冠脉病变Gensini评分与BNP水平呈正相关(r=0.51,P<0.01)。结论:对于左室收缩功能正常的多支血管病变的冠心病患者,其BNP水平明显升高,且与冠脉病变严重程度存在相关性。

Objective：To explore the value of brain natriuretic peptide （BNP） in prediction of the severity of coronary arterial lesion in patients with coronary heart disease （CHD） and normal left ventricular systolic function. Methods ： Results of coronary angiography and level of BNP within 24 hours after admission in 188 patients with stable angina and non-ST-ele- vation acute coronary syndromes were analyzed. According to the characteristics of coronary lesions Gensini Scores were determined. Results ： The levels of BNP were significantly higher in 2-vessels disease and 3-vessels disease than those in 1 -vessel disease and left stem disease （276.2 ＋ 193.7 pg/mL, 487.6 ＋ 312.3 pg/mL vs 105.5 ＋ 41.5 pg/mL, 102.5 ＋ 32.3 pg/mL,P 〈 0.05 ） , and the level of BNP in 3-vessels group was higher than that in 2-vessels group （ 487.6 ＋ 312.3 pg/mL vs 276.2 ＋ 193.7 pg/mL, P 〈 0.05 ）. NO significant difference was found between 1-vessel disease and left stem disease group（ P 〉 0.05 ）. Spearman correlation analysis showed a strong correlation between the level of BNP and coronary arterial lesion Gensini Score （r = 0.51, P 〈 0.01 ）. Conclusions： BNP level elevated significantly in patients with multi-vessel disease and normal left ventricular systolic function, and it is correlated with the severity of coronary arterial lesion.