外周血N末端脑钠肽前体、超敏C反应蛋白和胱抑素C对冠心病进展危险分层的意义

Significance of peripheral blood N-terminal pro-brain natriuretic peptide,high-sensitivity C-reactive protein and cystatin C in risk stratification for progression of coronary heart disease

目的:探讨外周血中N末端脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)和胱抑素C(CysC)对冠心病危险分层的意义。方法:选取2019年1月至12月广州新海医院收治的70例冠心病患者作为观察组,同期40例健康体检者作为对照组。检测所有研究对象血清NT-proBNP、hs-CRP和CysC水平,比较两组上述指标差异;根据全球急性冠状动脉事件注册(GRACE)评分将观察组患者分层为低危组(n=25)、中危组(n=29)和高危组(n=16),比较不同分层患者间血清指标水平差异;进一步行上述指标与冠心病进展危险分层的相关性分析。结果:①观察组血清NT-proBNP、hs-CRP和CysC表达水平均高于对照组(P<0.05);②血清NT-proBNP、hs-CRP和CysC的表达水平随冠心病严重程度增高而升高,低、中、高危组上述指标差异比较,差异均有统计学意义(P<0.05);③血清NT-proBNP、hs-CRP和CysC与冠心病进展危险分层呈正相关(r=0.841、0.745、0.702,P<0.05)。结论:冠心病患者的血清NT-proBNP、hs-CRP和CysC呈升高状态且与冠心病危险分层呈正相关,对冠心病的早期诊断和危险分层具有较高价值。

Objective:To investigate the significance of peripheral blood N-terminal pro-brain natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP)and cystatin C(CysC)in risk stratification of coronary heart disease(CHD).Methods:Seventy CHD patients admitted to Guangzhou Xinhai Hospital between January and December of 2019 were recruited as the study group,and a contemporary cohort of 40 health checkup individuals was recruited as the control group.Serum levels of NT-proBNP,hs-CRP and CysC were detected in all subjects and compared between the two groups.According to the Global Registry of Acute Coronary Events(GRACE)score,the study group was stratified into low-risk group(n=25),medium-risk group(n=29),and high-risk group(n=16).The three sub-groups were compared for differences in these serum indicators.The correlation between the these indicators and the risk stratification for CHD progression was analyzed.Results:(1)The serum expression levels of NT-proBNP,hs-CRP and CysC were higher in the study group than those in the control group(P<0.05);(2)The serum expression levels of NT-proBNP,hs-CRP and CysC increased with CHD severity,with statistically significant differences in these indicators among the low-,medium-and high-risk groups(P<0.05);(3)the serum levels of NT-proBNP(r=0.841,P<0.05),hs-CRP(r=0.745,P<0.05)and CysC(r=0.702,P<0.05)were positively correlated with the risk stratification of CHD progression.Conclusion:In CHD patients,serum NT-proBNP,hs-CRP and CysC levels are elevated and positively correlated with risk stratification of coronary heart disease,suggesting that these indicators are highly valuable for early diagnosis and risk stratification of CHD.