冠心病患者血浆D型利钠肽水平变化

Change of plasma dendroaspis natriuretic peptide( DNP ) contents in patients with coronary atherosclerotic heart disease

目的:研究冠心病患者血浆D型利钠肤(DNP)浓度的变化,探讨其在冠心病发生发展中的可能作用。方法:选取2013年7月至2014年4月福建医科大学附属协和医院因胸痛住院并行冠脉造影的患者,所有病例按照冠脉造影结果分为冠心病组和对照组,每个病例根据冠脉造影结果计算Gensini评分代表冠脉病变严重程度。ELISA测血浆DNP,环磷酸鸟苷(cGMP)及中性内肤酶(NEP)浓度。结果:共收集符合纳入标准的冠心病患者48例,冠脉造影冠脉正常者45例作为对照组。冠心病组血浆DNP水平高于对照组[(5060±1870)pg/mL vs(4250±1270)pg/mL,P<0.05];而冠心病组血浆cGMP、NEP浓度与对照组比较无统计学差异(P>0.05);不同类型冠心病组间DNP浓度没有统计学差异(P>0.05)。冠心病组血浆DNP浓度与Gensini评分进行Pearson相关性检验,二者间没有明显相关(r=0.105)。以是否冠心病为因变量,DNP、N端脑钠肤前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)及左室射血分数(LVEF)值为自变量进行Logistic回归分析示:DNP、NT-proBNP及hs-CRP与冠心病阳性率存在正相关,而LVEF值与冠心病阳性率存在负相关。结论:冠心病患者血浆DNP浓度升高,可能在冠心病发生与发展过程中起一定作用。

AIM：To investigate the change of plasma dendroaspis natriuretic peptide（DNP） levels in patients with coronary heart disease（CHD） and to explore the possible role of DNP during CHD development.METHODS：Patients admitted to Fujian Medical University Union Hospital because of chest pain and underwent coronary angiography were selected from July 2013 to April,2014.All selected cases were divided into the group of CHD and the control group according to the results of coronary angiography.The Gensini score was calculated according to the result of coronary angiography to quantify the severity of coronary lesion.Plasma DNP,cyclic guanosine monophosphate（cGMP） and neutral endopeptidase（NEP） concentrations were measured respectively with enzyme linked immunosorbent assay（ELISA）.RESULTS：48 patients with CHD met the inclusion criteria were enrolled and 45 patients with a negative coronary angiography result were enrolled as control group.The level of plasma DNP in CHD group was higher than that in control group[（5060 ± 1870） pg/mL vs（4250±1270） pg/mL,P0.05].There was no difference in plasma cGMP and NEP concentrations between the two groups（P 0.05）.There was no difference in DNP concentration between different types of CHD group（P0.05）.There was no significant correlation between the concentration of plasma DNP and Gensini score after Pearson correlation test（r =0.105）.Set CHD as dependent variable and DNP,N terminal B type natriuretic peptide（NT-proBNP）,high sensitivity C reactive protein（hs-CRP）,left ventricular ejection fraction（LVEF） as independent variable,Logistic regression analysis revealed that DNP,NT-proBNP and hs-CRP was positively correlated with the positive rate of CHD,and LVEF values was negatively correlated with the positive rate of CHD.CONCLUSION：The present study demonstrated that the plasma DNP was higher in patients with CHD,it may play a role in the development of CHD.