血浆B型脑钠肽与冠心病患者冠状动脉病变程度的相关性

Relationship between plasma level of brain natriuretic peptide and the severity of coronary artery lesions in patients with coronary artery disease

目的探讨冠心病患者血浆B型脑钠肽(BNP)水平与其冠状动脉病变程度的关系。方法 136例行冠状动脉造影(CAG)检查者,CAG正常者30例作为对照组;冠心病患者106例,根据冠状动脉病变支数分1支、2支、3支病变组分别为38例、36例、32例;按冠状动脉病变类型分A型、B型、C型病变组分别为42例、36例、28例。分析BNP水平在冠状动脉病变不同支数组、不同类型冠状动脉病变组间的关系。结果随着冠状动脉病变支数的增加,BNP明显增高,三支病变组较单支、双支差异有统计学意义(P<0.01);随着冠状动脉病变类型严重程度的增加,BNP明显增高,BNP在冠状动脉病变正常组、A型、B型、C型病变组间两两比较差异均有统计学意义(P<0.05),左心室舒张末期压力(LVEDP)在上述组间两两比较差异均有统计学意义(P<0.01),直线相关回归分析表明BNP水平与Gensini积分存在明显正相关关系(r=0.463,P<0.01)。结论 BNP可反映冠状动脉粥样硬化病变的程度,其能较灵敏地反映左心室功能受损的血流动力学变化。

ObjectiveTo investigate the relationship between plasma level of brain natriuretic peptide（BNP） and the severity of coronary lesions in patients with coronary artery disease（CAD）. Methods136 cases undergoing coronary angiography （CAG） and left ventricular pressure curves recording during CAG were enrolled. Among them there were 30 cases without CAD and 106 cases with CAD. The patients were further divided into 38 single-, 36 double-, 32 triple vessel disease groups and 42 A-, 36 B-, 28 C type of coronary lesions. Plasma BNP concentration was measured by radioimmunoassay. Left ventricular end-distolic pressure（LVEDP） were recorded by left ventricular pressure curves. Gensini score indicated the result of CAG. The relationship between BNP and the severity of coronary disease was analyzed.Results The levels of BNP, LVEDP and Gensini score were significantly different between 3 vessel group and 1, 2 vessel group, these parameters were also significantly different between A, B and C group.The BNP level were closely associated with Gensini score （r=0.463,P〈0.01）.Conclusion The plasma level of BNP can reflect the severity of coronary lesions to some extend, also was a sensitive biochemical marker for cardiac dysfunction.