冠心病患者血浆 BNP 及 hs－CRP 水平变化与冠状动脉病变程度的关系研究

摘要

目的：探讨冠心病患者血浆脑钠肽（ BNP ）和超敏C反应蛋白（ hs－CRP ）水平变化与冠状动脉病变程度的相关性。方法：选取本院收治的132例冠心病患者，根据临床症状分为急性心肌梗死组（47例），不稳定型心绞痛组（45例），稳定型心绞痛（40例）3组；根据冠状造影病变情况分为单支组（58例），双支组（49例）与多支组（25例），同时选取同期进行健康体检的健康者46例为对照组。比较不同组之间的血浆BNP及hs－CRP水平变化。结果：AMI组患者BNP 与hs－CRP 水平均显著高于对照组与UAP及SAP组（ P＜0．05）；UAP组患者BNP与hs－CRP水平较SAP组与对照组相比，亦有明显升高（ P＜0．05）；SAP组患者与对照组BNP 与hs－CRP 水平无明显变化，差异无统计学意义（ P＞0．05）。单支组、双支组与多支组患者制剂BNP 水平及hs－CRP 水平差异显著（ P＜0．05）。冠心病患者冠状动脉狭窄积分与血浆BNP（r＝0．543，P＝0．004）及hs－CPR均呈正相关（r＝0．358，P＝0．003）。结论：血浆BNP与hs－CRP在不同类型冠心病中差异显著，其浓度变化与冠状动脉病变程度呈正相关，均能独立作为预测斑块与炎症反应的严重程度的重要标记物，两者联合检测对于初步评估冠状动脉病变的范围与预后具有一定的临床参考价值。%Objective:To investigate relationship between plasma brain natriuretic peptide and high-sensitivity C-reactive protein in patients with coronary heart diseases ( CHD) .Method: 132 cases of pa-tients with CHD in our hospital were selected as the research group, They were divided into 47 cases of acute myocardial infarction (AMI) group, 45 cases of unstable angina pectoris(UAP) group, 40 cases of stable angina pectoris(SAP) group according to clinical symptoms.According to the scope of coronary artery dis-ease, the CHD group was divided into single vessel disease group ( 58 cases) , double vessel disease group (49 cases) and several vessel disease group (25 cases).At the same period, 45 healthy cases were selected as control group.All cases were respectively measured the BNP and hs-CRP levels.Result: The levels of BNP and hs-CRP in AMI group were significantly higher than the UAP , SAP and control group ( P <0. 05);The levels of BNP and hs-CRP in UAP group also increased significantly compared with control group ( P <0.05);While SAP group had no statistically significant difference between the control group ( P >0. 05) .The level of BNP and hs-CRP had significant difference between the single, double and multi vessel group (P <0.05).The level of BNP(r =0.543, P =0.004) and hs-CRP (r =0.358, P =0.358). Conclusion:The level of BNP and hs-CRP in different types of CHD had significant difference, which was positively correlated with the degree of coronary artery lesions .The level of BNP and hs-CRP could use as important marker for prediction of plaque and the severity of the inflammatory,which has certain clinical val-ue for the evaluation of coronary artery disease and prognosis.