非ST段抬高型急性冠脉综合征患者药物治疗前后血浆B型尿钠肽水平变化及其与冠脉病变程度的关系分析

Analysis of BNP level of patients with non-ST-elevationacute coronary syndrome before and after medication and their correlation with the severity of coronary lesions

目的 观察非ST段抬高型急性冠脉综合征（NSTE-ACS）患者药物治疗前后血浆B型尿钠肽（BNP）水平的变化,及BNP水平与冠脉病变程度的关系,及其对近期预后的判断价值.方法 选取2012年6月～2013年6月河北大学附属医院心内1科不稳定型心绞痛及NSTE-ACS且心功能正常的患者98例为研究对象,将其分为不稳定性心绞痛组（A组）48例,NSTE-ACS组（B组）50例.检测并比较两组患者入院时及治疗48 h前后BNP水平,分析入院BNP水平与冠脉病变程度的相关性,及BNP水平与出院3个月内心血管不良事件发生的关系.结果 入院时B组BNP水平明显高于A组[（417.69±86.74）ng/L比（167.23±66.83）ng/L],差异有统计学意义（P＜0.05）;治疗前A、B两组患者BNP水平[（167.23±66.83）ng/L、（417.69±86.74）ng/L]均高于治疗后[（85.29±23.62） ng/L、（184.12±48.96）ng/L,差异均有统计学意义（均P＜ 0.05）;冠状动脉3支与2支病变组BNP水平[（475.97±86.44）、（335.33±88.66）ng/L]明显高于1支病变组[（142.08±54.09） ng/L],差异均有统计学意义（均P＜0.05）;随着BNP水平的升高,3个月的心血管事件发生率有升高趋势（P＜0.05）.结论 BNP水平与心肌缺血程度密切相关,故测定外周血BNP水平对于判断冠状动脉严重程度及预测心血管不良事件有重要价值.

Objective To investgate the change of B-type natriuretic peptide （BNP） level of patients with non-ST-elevation coronary syndromes （NSTE-ACS） before and after medication,their correlation with the severity of coronary lesions,and the evaluate value of early prognostic.Methods A total of 98 patients who were diagnosed as unstable angina pectoris and NSTE-ACS without heart failure in First Cardiovascular Medicine Department of the Affiliated Hospital of Hebei University were selected as study objects,and they were divided into unstable angina pectoris group （group A）with 48 cases and NSTE-ACS group （group B） with 50 cases.The BNP level of two groups on admission and after 48 hours of medication were recorded and compared; the relationship between the BNP level on admission and severity of coronary lesions was analyzed.Results The BNP level of group B was higher than that of group A [（417.69±86.74） ng/L vs （167.23±66.83） ng/L],the difference was statistically significant （P 〈 0.05）; the BNP level of group A and B before medication [（167.23±66.83） ng/L,（417.69±86.74） ng/L] were obviously higher than those after medication [（85.29±23.62） ng/L,（184.12±48.96） ng/L],the differences were statistically significant （all P 〈 0.05）,The level of BNP in 2 and 3 vessels lesion group [（475.97±86.44）,（335.33±88.66） ng/L] were higher than those in 1 vessel lesion group [（142.08±54.09） ng/L],the differences were statistically significant （all P 〈 0.05）.With the increasing of the BNP levels,the incidence of cardiovascular event showed upward tendency （P 〈 0.05）.Conclusion The ischemia degree of cardiac muscle is closely correlated with the BNP level,the concentration of BNP in Peripheral blood plays an important role in assessing the degree of coronary lesions and calculating cardiovascular event.