血浆BNP、CRP、FBG、TNI水平对急性冠脉综合征的临床价值

Clinical value of plasma BNP,CRP,FBG and TNI levels in acute coronary syndrome

目的探讨血浆脑钠肽(BNP)、C反应蛋白(CRP)、纤维蛋白原(FBG)、肌钙蛋白I(TNI)浓度与急性冠脉综合征(ACS)之间的关系。方法将35例稳定型心绞痛(SA)和110例ACS患者作为治疗组,38例健康者作为对照组,其中ACS患者分为不稳定型心绞痛(UAP)组43例、ST段抬高型心肌梗死(STEMI)组29例、非ST段抬高型心肌梗死(NSTEMI)组38例,采用微粒子化学发光法、免疫荧光法、凝血酶凝固法、微粒子化学发光法分别测定血浆BNP、CRP、FBG、TNI浓度水平,根据冠状动脉病变严重程度及是否发生心血管意外分组比较BNP、CRP、FBG、TNI浓度变化,并进行统计学分析。结果各治疗组血浆BNP、CRP、FBG、TNI浓度均高于对照组;三支病变组高于双、单支病变组,双支病变组高于单支病变组;Gensini评分≥20分组高于Gensini评分<20分组;心血管意外发生组高于未发生组,差异均有统计学意义(P<0.05)。结论联合检测血浆BNP、CRP、FBG、TNI浓度水平,对疾病的诊断及预后观察、评估具有重要的临床意义。

Objective To investigate the relationship between plasma brain natriuretie peptide （ BNP）, C - reactive protein （CRP）, fibrinogen （FBG）, troponin I （TNI） concentrations and acute coronary syndrome （ACS）. Methods Thirty- five patients with stable angina （SA） and 110 patients with ACS were taken as the treatment group, and 38 healthy persons were taken as the control group, in which the ACS patients were divided into unstable angina pectoris （UAP）group（43 patients）, SI -segment elevation myocardial infarction （STEMI） group（29 patients） and non- ST- segment elevation myocardial infarction （NSTEMI） group（38 patients）. Micropartiele chemiluminescence method, immunofluoreseence and thrombin coagulation meth- od were used to measure the levels of plasma BNP, CRP, FBG and TNI separately. The concentration changes of BNP, CRP, FBG and TNI were compared for statistical analysis by dividing groups according to the severity of coronary artery disease and presence of cardiovascular accidents. Results The plasma BNP, CRP, FBG and TNI levels were all higher in treatment groups than control group, from high to low were three - vessel disease group, double - vessel disease group, single - vessel disease group in treatment groups. The plasma BNP, CRP, FBG and TNI levels were higher in group with Gensini score I〉 20 than group with Gensini score 〈 20, higher in groups with cardiovascular incidents than those without, and the differences all had statistical significance （P 〈 O. 05）. Conclusion The combined detection of plasma BNP, CRP, FBG and TNI concentrations has important clinical significance in diagnosis and prognosis evaluation of acute coronary syndrome.