联合检测BNP和hs-cTnT在不同类型急性冠状动脉综合征中的临床意义

Clinical significance of combined detection of BNP and hs-cTnT in different types of ACS

目的分析患者血清中脑钠肽(BNP)和超敏心肌肌钙蛋白T(hs-cTnT)水平在不同类型急性冠状动脉综合征(ACS)中的临床意义。方法选取ACS住院患者187例,其中不稳定型心绞痛(UA)组52例、急性非ST段抬高型心肌梗死(NSTEMI)组61例、急性ST段抬高型心肌梗死(STEMI)组74例,于入院当天检测血清中BNP和hs-cTnT水平。另选取无器质性心脏病患者100例作为对照组。结果 ACS患者血清中BNP和hs-cTnT水平显著高于对照组,差异具有统计学意义(P<0.012 5)。Pearson相关分析显示,ACS患者血清中BNP和hs-cTnT无相关性(P=0.471)。亚组分析显示,ACS患者血清中hs-cTnT水平在UA组、STEMI组、NSTEMI组中依次递增,差异有统计学意义(P<0.012 5)。3个亚组中,预后不良的患者血清BNP水平均高于好转出院患者,差异有统计学意义(P<0.05)。结论 BNP水平与ACS患者住院期间的转归密切相关,hs-cTnT能在一定程度上提示病情变化。联合检测BNP和hs-cTnT对于ACS疾病的辅助诊断有重要临床意义。

Objective To analyze the clinical significance of combined detection of serum brain natriuretic peptide（BNP） and hy- persensitive cardiac troponin T（hs-cTnT） levels in patients with different types of acute coronary syndrome（ACS）. Methods A to- tal of 187 patients with ACS were enrolled,including 52 patients with unstable angina（UA）,61 patients with non ST segment ele- vation myocardial infarction（NSTEMI） and 74 patients with ST segment elevation myocardial infarction（STEMI）. Serum BNP and hs-cTnT levels were measured on the day of admission. Another 100 cases without organic heart disease were selected as healthy control group. Results The levels of BNP and hs-cTnT in ACS patients were significantly higher than those in the control group （P〈0. 012 5）. Pearson correlation analysis showed that serum levels of BNP and hs-cTnT in ACS patients had no correlation（P= 0. 471）. In the subgroups,the level of hs-cTnT in ACS patients from low to high were in UA group, STEMI group and NSTEMI group（P〈0. 012 5）. In the three subgroups, the patients with poor prognosis serum BNP levels were significantly higher than those of patients who had been discharged from hospital,the differences were statistically significant（P〈0.05）. Conclusion The level of BNP is closely related to the outcome of hospitalization in ACS patients,hs-cTnT could indicate the change of the disease. There- fore,the combined detection of serum BNP and hs-cTnT for the diagnosis of ACS disease has important clinical significance.