NT-proBNP在不同冠心病患者中的临床意义及其与冠脉病变支数相关性分析

摘要

[Objective]To explore the level of N-terminal brain natriuretic peptide(NT-proBNP) in differ ent types of coronary heart disease patients and its correlation with the extent of coronary artery lesion.[Methods]Seventy three patients with coronary heart disease including 26 stable angina pectoris(SAP), 18unstable angina pectoris(UAP) and 29 acute myocardial infarction(AMI) in our hospital from October 2009 to December 2010 were selected.Plasma NT-proBNP was measured by using electrochemiluminescence immuno assay.NT-proBNP was transformed into (e)n NT-proBNP by natural logarithm((e)n ) treatment for the normal distribution.The differences among groups were compared.Coronary arteriography(CAG) was performed for all patients within 14 days after admission.[Results]The level of (e)n NT-proBNP in AMI group was higher than that in UAP group, and that in UAP group was higher than that in SAP group( P ＜0.05).There was good positive correlation between (e)n NT-proBNP level and the extent of coronary artery lesion in all patients( P ＜0.01).[Conclusion]There is significant difference in NT-proBNP level among the patients with different kinds of coronary heart diseases.NT-proBNP can reflect the degree of myocardial ischemia.NT-proBNP is significantly related with the extent of coronary artery lesions.The measurement of plasma NT-proBNP may be valuable for the reference of the degree of coronary artery disease.%[目的] 探讨N末端-脑利钠肽前体(NT-proBNP)在不同类型冠心病患者中水平及其与冠脉病变支数的相关性.[方法]连续入选2009年10月至2010年12月住入本科的73例冠心病病人,其中稳定型心绞痛组(SAP)24例、不稳定型心绞痛(UAP)组19例、急性心肌梗死(AMI)组30例,采用化学发光法测定NT-proBNP,因各组间NT-proBNP不符合正态分布,经自然对数()处理后NT-proBNP符合正态分布,比较各组间的差异.所有患者均在入院后14 d内行冠脉造影检查.[结果]AMI组、UAP组、SAP组各组间NT-proBNP水平依次高于后一组(P＜0.05).所有患者的NT-proBNP与其冠脉病变支数有良好的正相关(P＜0.01).[结论]不同类型冠心病患者血清NT-proBNP浓度存在差异,NT-proBNP可以反映心肌缺血的程度.NT-proBNP与冠脉病变支数有明显的相关性.测量血浆NT-proBNP可能对冠脉病变程度提供参考价值.