冠心病患者血浆BNP、HCY、CRP水平变化分析

Analysis of Changes of BNP, HCY and CRP Plasma Levels in Patients with Coronary Heart Disease

目的 :检测冠心病患者血浆中BNP、HCY、CRP水平变化 ,探讨冠心病发病机制及不稳定性心绞痛治疗前后对其影响。方法 :用化学发光和酶联免疫分析 ,对 14 6例冠心病患者和 30例正常对照者血浆BNP、HCY、高敏 -CRP水平变化及相关性进行研究 ,同时对 5 2例UAP经皮冠状动脉成形术 (PTCA)治疗前后对上述三项指标的变化进行分析。结果 :冠心病患者与正常对照组比较BNP水平有显著性差异 (p <0 0 1) ,尤其是AMI和UAP组比SAP组升高更明显 ;CRP水平比正常对照组明显增高 (p <0 0 5 ) ,特别是不稳定心绞痛和急性心肌梗塞组升高明显 (p <0 0 0 1) ;AMI组血浆中HCY水平明显高于正常和其它两组 ,HCY、CRP、BNP三项在UAP组中治疗前后比较差异显著 (p <0 0 5 )。 结论 :BNP、CRP、HCY参与了冠心病的发病过程 ,并可预测心肌梗塞病人远期心功能恢复的情况 ,UAP组经PTCA支架术后三项指标均明显降低 ,可作为疗效观察的一个重要参数 ,HCY参与了冠状动脉粥样硬化的全过程及急性心肌梗塞的发病始末。但其参与的机制有待进一步探讨。

Objective To investigate the changes of plasma levels of BNP, HCY and CRP in patients with coronary heart disease of various forms, particularly the changes in UAP patients after treatment (PTCA) and to study the possible patho-physiologic implications. Methods Plasma BNP, HCY and supersensitive CRP levels in 146 patients with coronary heart disease and 30 controls were determined with chemiluminescence method. (for BNP) and ELISA (for HCY and CRP). A second measurement of these three substances were performed in 52 UAP patients after treatment with PTCA. Results Plasma BNP and CRP levels in the patients were significantly higher than those in the controls ( p <0 01 and p <0 05 respectively), especially in patients with AMI and UAP (p<0 001 for CRP). HCY levels in AMI patients were the highest among the levels in all tested subjects. In UAP patients there were significant differences between the levels of the three markers before and after treatment ( p <0 05). Conclusion BNP, CRP and HCY participate in development of coronary heart disease. Dynamic changes of their plasma levels may reflect the status of cardiac function recovery after AMI. In UAP patients after PTCA decline of the levels of the three markers indicates effective treatment. HCY particpates in the whole course of development of coronary atherosclerosis and AMI; the precise mechanism remains to be elucidated.