Objective To discuss the plasma level and clinical significance of NT - proBNP in Patients with Acute Coronary Syndrome ( ACS ).Methods 322 patients with ACS were selected, among which 207 cases in acute myocardial infarction ( AMI ) group ( including ST elevation myocardial infarction and non - ST elevation myocardial infarction ), 115 cases in unstable angina pectoris ( UAP ) group, and 45 cases in normal control group.Plasma level of NT - proBNP, cTnT and hs -CRP were detected, and LVEF was tested by ultrasonic cardiography.Results CD AMI patients had significantly higher NT -proBNP levels ( 897.6 [219.4 ～ 1918.5]pg/ml ) than UAP group ( 182.1 [84.9 ～ 596.2]) ( P ＜ 0.05 ).Both of the two groups had significantly higher NT - proBNP levels than normal control group ( 117.7 [66.6 ～ 213.2]pg/ml ) ( P ＜ 0.05 ).(2) The plasma level of NT - proBNP was positively correlated with hs - CRP ( r =0.451, P =0.000 ) and cTnT ( r =0.183 , P = 0.001 ), and negatively correlated with LVEF ( r = - 0.423 , P = 0.000 ).(3) The plasma level of NT - proBNP was significantly positively correlated with the lesion of coronary artery ( P ＜0.001 ).Conclusion NT - proBNP can be an index judging the range and severity of ischemia myocardial and impaired left ventricle.Detecting plasma level of NT - proBNP in ACS patients can be beneficial in the early risk stratification and clinical therapy.%目的 探讨急性冠脉综合征(ACS)患者血浆氨基末端脑钠肽前体(NT-proBNP)水平及其临床意义.方法 选取临床上诊断为ACS的患者322例,其中急性心肌梗死(AMI)患者207例(AMI组包括ST段抬高性心肌梗死和非ST段抬高性心肌梗死),不稳定心绞痛(UA)患者115例(UA组);同时选取冠状动脉造影正常者45例作为正常对照组.检测血浆NT-proBNP及肌钙蛋白T(cTnT)、超敏C反应蛋白(hs-CRP)水平.彩色超声心动图检测其左室射血分数(LVEF).结果 (1)AMI组NT-proBNP水平为897.6[219.4～1918.5]pg/ml,明显高于UA组的182.1[84.9～596.2]pg/ml,且两组患者NT-proBNP水平均明显高于正常对照组的117.7[66.6～213.2]pg/ml,差异均有统计学意义( P ＜0.05).(2)NT-proBNP与hs-CRP、cTnT呈正相关(r=0.451,P =0.000;r=0.183,P =0.001),与LVEF呈负相关(r=-0.423,P =0.000).(3)不同冠状动脉病变程度者NT-proBNP水平间差异有统计学意义( P ＜0.001).结论 NT-proBNP可以作为心肌缺血范围和严重程度以及左心室功能受损的指标,测定ACS患者的NT-proBNP水平,有助于对该类患者进行早期危险分层,指导临床治疗方案的制定.
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