冠心病患者冠状动脉病变程度与血尿酸、脑型钠尿肽及超敏C反应蛋白水平的相关性

The correlations between the degree of coronary lesion and levels of serum uric acid,brain natriuretic peptide and high sensitivity C reactive protein in patients with coronary artery disease

目的：探讨冠心病（CHD）患者冠状动脉病变程度与血尿酸（UA）、脑型钠尿肽（BNP）及超敏C反应蛋白（hs-CRP）水平变化的相关性。方法：选择疑似CHD患者72例,入院后均行择期冠状动脉造影术,确诊CHD患者52例,根据临床症状及相关检查分为急性心肌梗死组（AMI组,23例）和不稳定型心绞痛组（UAP组,29例）,其中AMI组患者入院时有溶栓适应证无禁忌证者均给予尿激酶静脉溶栓治疗;根据冠状动脉造影病变情况分为单支组（18例）、双支组（19例）与3支及以上（多支）组15例。对照组为经造影排除CHD诊断者20名。比较各组血UA、BNP及hs-CRP的水平变化。结果：AMI组患者血UA、BNP与hs-CRP水平均显著高于UAP组和对照组（P〈0.05-P〈0.01）,UAP组患者血UA和BNP水平明显高于对照组（P〈0.01）。双支与多支组患者血UA、BNP及hs-CRP水平均显著高于单支组（P〈0.01）,而多支组患者3项指标亦均高于双支组（P〈0.05-P〈0.01）。结论：血UA、BNP与hs-CRP与CHD患者冠状动脉病变程度有一定关系,可用来评估患者心肌缺血程度及作为危险分层的指标。

Objective： To investigate the correlations between the degree of coronary lesion and levels of serum uric acid（ UA）,brain natriuretic peptide（ BNP） and high sensitivity C-reactive protein（ hs-CRP） in patients with coronary artery disease（ CHD）. Methods：The coronary angiography in 72 suspect CHD cases were examined,and 52 pateints with CHD were diagnosed. The 52 CHD patients were divided into the acute myocardial infarction group（ AMI group,23 cases） and unstable angina pectoris group（ UAP group,29cases）. The AMI group with thrombolytic therapy indication and without contraindication were treated with intravenous urokinase. Fiftytwo CHD cases were divided into the one-vessel disease group（ 18 cases）,two-vessel disease group（ 19 cases） and multiple-vessel disease group（ 15 cases） according to the lesion degree detected by coronary angiography. The 20 cases without CHD were set as the control group. The serum levels of UA,BNP and hs-CRP in different groups were compared. Results： The serum levels of UA,BNP and hs-CRP in AMI group were significantly higher than those in UAP group and control group（ P〈0. 05 to P〈0. 01）. The serum levels of UA and BNP in UAP group were significantly higher than those in control group（ P〈0. 01）. The serum levels of UA,BNP and hs-CRP in two- and multiple-vessel disease groups were obviously higher than those in one-vessel disease group（ P〈0. 01）,the serum levels of UA,BNP and hs-CRP in multiple-vessel disease group were higher than those in two-vessel disease group（ P〈0. 05 to P〈0. 01）.Conclusions： The serum levels of UA,BNP and hs-CRP have certain correlations with the lesion degree of coronary in CHD patients,and those indexes can be used to evaluate the degree of myocardial ischemia,and acted as the indexes of risk stratification.