血浆脑钠素和超敏C反应蛋白联合监测对急性冠脉综合征的评估价值.pdfVIP

中国临床医学 2007年12月 第 14卷 第6期 Clinical Medical Journal of China，2(1I)7．Vo1．14一No．6 767 论著 血浆脑钠素和超敏C反应蛋白联合监测对 急性冠脉综合征的评估价值 杨婉花 汪自龙 欧阳平 摘要 目的：探讨血浆脑钠素(BNP)和超敏 C反应蛋白(hs—CRP)水平联合监测对急性冠脉综合征(ACS)早期病情及预后的 评估价值。方法：测定5()例ACS患者发病24 h及 14 d和25例冠脉造影无明显狭窄对照组患者的血浆BNP和 hs CRP水 平，分析其与临床指标的关系。结果：ACS患者发病24 h、14 d血浆BNP和hs—CRP水平均明显高于对照组(P％O．O1)，急性 心肌梗死(AMI)组的BNP和hs—CRP水平亦均高于不稳定性心绞痛(UAP)组(_F)()．05)。ACS患者发病后24 h的血浆BNP 和hs—CRP水平与冠脉病变积分(Gensini积分)、冠心病危险因素积分(RSC)无显著相关，但第14天的血浆BNP与Gensini积 分呈正相关( 一0．411，P0．05)，第14天的血浆hs—CRP水平与 RSC、Gensini积分均呈正相关( 一 0．375，P0．05；r= 0．423，P％0．05)。第14天的血浆BNP明显升高组(80 Pg·ml 组)，其hs—CRP水平显著高于非高BNP组(80 Pg· ml。。)。4周后的左室射血分数(I VEF)明显低于非BNP明显升高组(80 Pg·ml’组)(P()．05)。结论：血浆BNP和hs— CRP水平的联合监测有助于ACS病情及预后的评估，对ACS的危险分层具有一定临床指导意义。 关键词 急性冠脉综合征； 血浆脑钠素； 超敏c反应蛋白； 预后 中图分类号 R541．4 文献标识码 A The Value of Plasma Brain Natriuretic and High Sensitivity C-reactive Protein in Acute Coronary Syndrome ，A G W 77，?““ WA G Zilong OUYANG Pbtg Department of Cardiology，SongJiang Hospital Al『’filiated to First People s Hospital fJ厂Shanghai Jiaotong University Shanghai 2()1 6()() Abstract Objective： Io investigate the value of plasma brain natriuretic(BNP)and high sensitivity C—reactive protein(hs— CRP)in evaluating the prognose of patients with acute coronary syndrome(ACS)．Methods：The levels of plasma BNP(by flu— oroimmunoassay)and hs—CRP(by immunoturbidimetry)were measured in 5()patients with ACS after symptom onset 24 hour and 1 4 days．and in 25 normals as wel1．Their relation to clinical index were analyzed．Results：It was found that levets of plas— ma BNP and hs—CRP in ACS group were significantly higher than those in normal group(P()．0 1)，levels of them in AM1 were significantly higher than those in UAP group(P％0．05)．There was no correlation in the levels of plasma