N末端脑钠肽前体及超敏C反应蛋白对急性冠状动脉综合征的诊断价值及相关性研究

Diagnostic value and relationship research between N-terminal pro-brain natriuretic peptide and high sensitive C-reactive protein in acute coronary syndrome

目的 探讨N末端脑钠肽前体（NT-proBNP）及超敏C反应蛋白（hs-CRP）对急性冠状动脉综合征（ACS）的诊断价值及相关性.方法 选取108例ACS患者（ACS组）和84例健康体检者（对照组）作为研究对象,其中非ST段抬高型心肌梗死（NSTEMI） 37例（NSTEMI组）,ST段抬高型心肌梗死（STEMI） 35例（STEMI组）,不稳定型心绞痛（UA） 36例（UA组）,观察并比较各组血清NT-proBNP及hs-CRP水平,并进行相关性分析.结果 ACS组患者血清NT-proBNP、hs-CRP明显高于对照组[（1264.8±671.8） ng/L比（337.0±10.6） ng/L,（15.42±8.03） mg/L比（6.92±0.59） mg/L],差异有统计学意义（P＜0.05）.hs-CRP和NT-proBNP呈显著正相关（r=0.46,P＜ 0.05）.NSTEMI组、STEMI组、UA组及对照组血清NT-proBNP组间比较差异均有统计学意义（P＜0.05）；NSTEMI组、STEMI组、UA组患者血清hs-CRP均显著高于对照组,差异有统计学意义（P〈0.05）,但STEMI组与UA组比较差异无统计学意义（P＞0.05）.随着冠状动脉病变支数的增加,患者血清NT-proBNP和hs-CRP水平亦随之升高,差异有统计学意义（P＜0.05）.结论 联合检测NT-proBNP和hs-CRP可以对ACS做出早期诊断,并可作为评估预后和危险分层的重要参考指标.

Objective To evaluate the levels of plasma N-terminal pro-brain natriuretic peptide （NT-proBNP）,high sensitive C-reactive protein （hs-CRP） and the correlation in the patients with actue coronary syndrome （ACS）.Methods One hundred and eight patients with ACS as ACS group,while 84 healthy controls as control group.ACS group included non-ST-segment elevation myocardial infarction （NSTEMI） group （37 cases）,ST-segment elevation myocardial infarction （STEMI） group （35 cases）,unstable angina（UA） group（36 cases）.Recorded and compared the levels of NT-proBNP and hs-CRP in two groups,and the correlation was analyzed.Results The levels of NT-proBNP and hs-CRP in ACS group were significantly higher than those in control group [（1264.8 ±671.8） ng/L vs.（337.0 ± 10.6） ng/L,（15.42 ± 8.03） mg/L vs.（6.92 ± 0.59） mg/L,P 〈 0.05].The correlation between hs-CRP and NT-proBNP level was positive in ACS （r =0.46,P 〈 0.05）.The levels of NT-proBNP in NSTEMI group,STEMI group,UA group,control group,differences among groups were statistically significant （P 〈 0.05）.The levels of hs-CRP in NSTEMI group,STEMI group,UA group were significantly higher than those in control group （P 〈 0.05）.There was no statistically significant difference in the levels of NT-proBNP between STEMI group and UA group （P 〉0.05）.And the levels of NT-proBNP and hs-CRP increased with the increasing of coronary artery lesion counts,the differences among groups were statistically significant （P 〈0.05）.Conclusion ACS can be early diagnosed through combined detection of NT-proBNP and hs-CRP,and NT-proBNP and hs-CRP can be used as important makers to evaluate prognosis and risk stratification.