急性心肌梗死患者N末端脑钠肽前体、C反应蛋白、同型半胱氨酸检测的临床意义

Clinical Significance of N-terminal Pro-Brain Natriuretic Peptide、C-Reactive Protein and Homocysteine in Patients with Acute Myocardial Infarction

目的为探讨急性心肌梗死(AMI)患者血浆中N末端脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)和同型半胱氨酸(Hcy)的水平及临床意义。方法采用免疫化学发光法测定100例健康者和90例AMI患者的血浆NTproBNP,采用胶乳增强免疫比浊法测定CRP,采用循环酶法检测Hcy并对AMI患者在住院期间及随后进行随访,观察其预后状况。结果 AMI患者发作期血浆NT-proBNP浓度(534.55±106.44 ng/L),明显高于对照组的(158.13±18.93ng/L),差异有统计学意义(P<0.01)。CRP水平较对照组明显增高.差异有统计学意义(P<0.01).而Hcy水平明显高于对照组.差异有统计学意义(P<0.01)。随访90例AMI患者结果发现,发生心血管病事件组血浆NT-proBNP、CRP、Hcy浓度明显高于未发生心血管病事件组,二者差异有统计学意义(P<0.05)。结论 NT-proBNP浓度在AMI后迅速大幅度升高,CRP、Hcy明显高于对照组,NT-proBNP、CRP和Hcy 3项均参与了AMI的发病过程,并可预测患者的远期心功能恢复情况。

Objective To investigate the acute myocardial infarction（AMI）patients plasma N-terminal probrain natriuretic peptide （NT-proBNP）, C reactive protein（CRP） and homocysteine （Hcy）level and its clin- ical significance. Method Immune chemiluminescence was used to determine the plasma NT-proBNP in 100 healthy persons and 90 patients with AMI, using latex-enhanced turbidimetric method determination of CRP, by enzymatic cycling assay for detection of Hcy and AMI of patients in the hospital and the subsequent follow- up,to observe the prognosis. Results AMI patients plasma NT-proBNP concentration （534.55 ± 106.44 ng/ L）, significantly higher than that in control group（ 158.13± 18.93 ng/L） ,the difference was statistically sig- nificant（P 〈 0. 01 ）. The level of CRP was significantly higher than the control group. The difference was sta- tistically significant （P 〈 0. 01 ）. While the Hcy level was significantly higher than that of the control group. The difference was statistically significant（P 〈 0.01 ）. Follow-up of 90 patients with AMI results, cardi- ovascular events of plasma NT- proBNP, CRP, Hcy was significantly higher than that in non cardiovascular eventgroup, there was significant difference between the two groups （ P 〈 0.05 ）. Conclusion NT- proBNP concentration greatly increases after the AMI, and Hcy as well as CRP are significantly higher in the experi- mental group than those in the normal control group. NT-proBNP, CRP and Hcy are all involved in thc patho- genesis of acute myocardial infarction process ,and can predict patients long-term forecast cardiac function re- covery.