急性冠状动脉综合征患者脑钠肽水平变化的临床观察

摘要

目的 探讨急性冠状动脉综合征(ACS)患者经保守或介入治疗后血浆脑钠肽水平的变化.方法 ACS患者95例,介入治疗37例为介入组,保守治疗58例为保守组,健康体检者41例为对照组.酶联免疫吸附法(ELISA)测定入院即刻、第3天、第5天、第10天4个时间点的血浆脑钠肽水平.结果 保守组的血浆脑钠肽水平在入院即刻、第3天、第5天均高于对照组(P＜0.05),但3个时点动态变化不大(P=0.427);介入组在入院即刻、第3天、第5天的血浆脑钠肽水平也均高于对照组(P＜0.05),但3个时点动态变化不大(P=0.544).在第10天保守组和介入组的血浆脑钠肽水平都显著回降,但仍高于对照组且有统计学意义(P=0.025,P=0.012).入院即刻、第3天、第5天及第10天介入组和保守组血浆脑钠肽水平比较无统计学意义.结论 急性冠状动脉综合征患者血浆脑钠肽水平第1周内保持较高水平,第10天显著回降,但仍高于正常水平.急性冠状动脉综合征患者经保守或介入治疗后10 d内血浆脑钠肽水平的变化情况相近.%Objective To obselwe the changes of plasma Brain natriuretic peptide(BNP)in patients with acute coronary artery syndrome(ACS)after percutaneous coronary intervention(PCI)or medical therapy.Methods Thirty-seven ACS patients with percutancous coronary intervention(PCI)were enrolled;meanwhile,58 patients with medical treatment were established as a medical group,with 41 healthy persons as a control group.Enzyme-linked immunoadsorbent assay(EUSA)method was used for detecting the concentration of plasma BNP.Blood BNP samples were respectively collected on admission,3rd day,5th day and 10th days after admission.Results The plasma BNP levels in PCI group and medicine group were all significantly higher than control group on admission,3rd day,were 5th day(P＜0.05).But no significant differences were shown among the 3 time points within the two study groups(P＞0.05).On the 10th day,the plasma BNP level in PCI group and medicine group all decreased,but were still significantly higher than control group(P＜0.05). Meanwhile,there were no significant differences of plasma BNP level between PCI group and medicine group on admission,3rd day,5th day(P＞0.05).Conclusion The plasma BNP in patients with ACS increased during the first week.It decreased but remained an insignificant higher level at the 10th day than normality.PCI and medical therapy showed the same effect on plasma BNP level in patients with ACS.