脑钠肽、高敏C反应蛋白对ACS患者PCI术中冠状动脉无复流的影响

Effects of brain natriuretic peptide and high sensitivity C reactive protein on coronary artery no-reflow in patients with acute coronary syndrome undergoing PCI surgery

目的探讨血浆脑钠肽(NBP)、高敏C反应蛋白(hs-CRP)水平对急性冠脉综合征(ACS)患者冠状动脉介入术(PCI)发生术中冠状动脉无复流的影响。方法选择2014年6月至2016年12月在广元市第一人民医院接受PCI手术治疗的113例ACS患者,按照PCI手术是否发生术中冠状动脉无复流分为血流正常组78例与无复流组35例,比较两组患者术前、术后血浆NBP、hs-CRP水平,分析血浆NBP、hs-CRP水平与冠状动脉无复流的相关性。结果术前血流正常组患者的BNP、hs-CRP水平分别为(91.82±30.21)pg/m L、(2.57±0.75)mg/L,术后分别为(91.31±28.05)pg/m L、(2.76±0.56)mg/L;无复流组患者术前分别为(122.36±30.83)pg/m L、(3.08±0.72)mg/L,术后分别为(155.72±47.64)pg/m L、(3.83±1.26)mg/L,手术前和手术后,血流正常组患者的BNP和hs-CRP水平均低于无复流组,差异均具有统计学意义(P<0.05);且无复流组患者手术后的BNP水平和hs-CRP水平均高于手术前,差异均具有统计学意义(P<0.05);经Pearson相关分析结果显示,血浆BNP及hs-CRP水平与PCI术后无复流之间呈高度正相关(r=0.752、0.805,P<0.05)。结论较高水平BNP、hs-CR能够诱导急性冠脉综合征患者PCI手术发生术中冠状动脉无复流,对于高水平的BNP、hs-CR急性冠脉综合征患者,应早期干预,以降低BNP、hs-CR水平,减少PCI术中冠状动脉无复流的发生。

Objective To explore the effect of brain natriuretic peptide（BNP） and high sensitivity C reactive protein（hs-CRP） on no-reflow phenomenon in acute coronary syndrome（ACS） patients with percutaneous coronary intervention（PCI）. Methods A total of 113 ACS patients, who admitted to our hospital and underwent PCI surgery from June 2014 to December 2016, were enrolled and divided into the normal blood flow group and the no-reflow group according to with or without no-reflow. The preoperative and postoperative plasma NBP, hs-CRP level of the two groups were detected, and the relationships between plasma NBP and hs-CRP levels and coronary artery reflow were analyzed.Results The preoperative levels of BNP and hs-CRP in the normal blood flow group were respectively（91.82±30.21）pg/m L and（2.57±0.75） mg/L, and the postoperative levels of BNP and hs-CRP in the normal blood flow group were respectively（91.31 ± 28.05） pg/m L and（2.76 ± 0.56） mg/L. The preoperative levels of BNP and hs-CRP in the no-reflow group were respectively（122.36±30.83） pg/m L and（3.08±0.72） mg/L, and the postoperative levels of BNP and hs-CRP in the no-reflow group were respectively（155.72±47.64） pg/m L and（3.83±1.26） mg/L. Before and after surgery, the levels of BNP and hs-CRP in the normal blood flow group were significantly lower than those in the no-reflow group（P〈0.05）; while the postoperative levels of BNP and hs-CRP were significantly higher than the preoperative levels in the no-reflow group（P〈0.05）. Pearson correlation analysis showed that plasma BNP and hs-CRP levels were highly correlated with no-reflow after PCI（r=0.752, 0.805, P〈0.05）. Conclusion The high levels of BNP and hs-CR maybe induce no reflow in ACS patients with PCI. For ACS patients with the high level of BNP and hs-CR should be early intervened to reduce BNP and hs-CR levels, for reducing the incidence of coronary no-reflow during PCI.