血清N末端脑钠肽前体浓度与冠状动脉闭塞患者冠状动脉侧支循环分级的关系

Correlation between serum N-terminal pro-brain natriuretic peptide and grading of coronary collateral circulation in patients with coronary occlusion

目的研究血清氨基末端脑钠肽前体（N—terminalpro—brainnatriureticpeptide，NT-proBNP）浓度与冠状动脉闭塞患者冠状动脉侧支循环分级的关系。方法回顾性分析2013年1月至2014年12月在湘潭中心医院心内科住院的122例急性冠状动脉综合征患者的临床资料，观察并分析血清NT—proBNP浓度与冠状动脉闭塞患者冠状动脉侧支循环分级的关系以及侧支循环形成的影响因素。结果本组闭塞冠状动脉侧支循环0～1级患者，血清NT—proBNP浓度为1978（48～9538）ng／mL，2--3级患者血清NT-proBNP浓度为649（13～1438）ng／mL。Spersman相关性分析结果显示，本组患者闭塞冠状动脉侧支循环分级与血清NT—proBNP浓度呈负相关（r=-0．851。P〈0．05）。BinaryLogistic回归分析结果显示，血清NT-proBNP浓度是促进冠状动脉侧支形成的独立性影响因素（OR=0．995，95％CI：0．992～0．998）。结论血清NT—proBNP浓度与冠状动脉闭塞患者冠状动脉侧支循环分级关系密切．即血清NT—proBNP浓度越高冠状动脉闭塞患者籍状动脉侧支循环分级越低。临床医生应高度重视对血清NT—proBNP浓度的监测，为急性冠状动脉综合征患者的临床诊治提供科学参考。

Objectives To study the correlation between serum concentration of N-terminal pro-brain natriuretic peptide （NT-proBNP） and grading of coronary collateral circulation in patients with coronary occlusion. Methods Clinical data of 122 patients with acute coronary syndrome hospitalized in the Department of Cardiology of Xiangtan Central Hospital from January 2013 to December 2014 were reviewed. The correlation between serum concentration of NT-proBNP and grading of coronary collateral circulation in patients with coronary occlusion was analyzed. Meanwhile, the influencing factors for formation of collateral circulation were observed. Results Serum concentration of NT-proBNP in patients at 0-1 grade of coronary collateral circulation was 1 978 （48-9 538） ng/mL, while in patients at 2-3 grade of coronary collateral circulation was 649 （13-1438 ）ng/mL. Spersman correlation analysis indicated that grading of occlusive coronary collateral circulation was negatively correlated with serum concentration of NT-proBNP （r=-0.851,P〈0.05）. Binary Logistic regression analysis implied that serum concentration of NT-proBNP was an independent determinant of formation of coronary collateral circulation （OR=0.995, 95%CI： 0.992-0.998）. Conclusions Serum concentration of NT- proBNP is closely correlated with grading of coronary collateral circulation in patients with coronary artery occlusion, in which, the higher the serum concentration of NT-proBNP is, the lower the grading of coronary collateral circulation is. Therefore, monitoring of serum concentration of NT-proBNP merits clinical attention, which provides scientific references for clinical diagnosis and treatment of acute coronary syndrome.