NT-proBNP、Hcy诊断急性冠脉综合征的临床研究

The study of N-terminal pro-brain natriuretic peptide and homocysteine in patients with acute coronary syndrome

目的探讨NT—proBNP、Hcy诊断急性冠脉综合征（ACS）的临床意义。方法对70例AMI患者、50例UAP患者、50例SAP患者和50例健康体检者的血浆NT—proBNP、Hey水平进行比较分析。ACS患者均行冠状动脉造影术，并对其病变程度进行评估。结果AMI组和UAP组患者血浆NT—proBNP水平显著高于SAP组及对照组（P〈0．05），而SAP组与对照组比较差异无统计学意义（P〉0．05）；ACS组、SAP组血浆Hcy水平均高于对照组，各组间比较差异有统计学意义（P〈O．05）。随着冠脉病变支数增加，ACS患者血浆NT—proBNP、Hcy水平逐渐升高（P〈0．05）。ACS患者中，心血管事件组血浆NT—proBNP、Hcy水平明显高于无心血管事件组（p〈0．05）。结论急性冠脉综合征患者的血浆NT—proBNP、Hcy水平均与冠状动脉粥样化病变程度密切相关，是ACS心血管不良事件的预测因子。

Objective To discuss the clinical significance of N-terminal pro-brain natriuretic peptide and homocysteine in patients with acute coronary syndrome. Methods The plasma N-terminal pro-brain natriuretic peptide and homocysteine were measured with in 70 patients with acute myocardial infrction,50 patients with un- stable angina pectoris,50 patients with stable angina pectofisand and 50 normal medical persons. All the patients received the coronary angiography,and were evaluated severity of coronary atherosclerosis. Results The plasma N-terminal pro-brain natriuretic peptide levels in all the patients with acute coronary syndrome were significantly hingher than those of patients with stable angina pectofisand and the control group （P〈0.05）. While the difference was not statistically significant in stable angina pectofisand group and the control group （P〉0.05）.The plasma ho- mocysteine levels in all the patients with acute coronary syndrome and stable angina pectofisand are higher than the control group, each group is significant difference （P〈0.05）.The plasma N-terminal pro-braln natriuretic pep- tide and homoeysteine levels in all the patients with acute coronary syndrome were increased with the increasing severity of coronary atherosclerosis （P〈0.05）. In acute coronary syndrome patients,the NT-proBNP and homocys- teine levels with major adverse cardiac events group were significantly hingher than those of patients without major adverse cardiac events group. Conclusion The plasma N-terminal pro-brain natriuretic peptide and homocysteine levels in all the patients with acute coronary syndrome were closely correlated to the degree of coronary atheroma pathological damage, and were the acute coronary syndrome patients＇s major adverse cardiac events predictors.