B型钠尿肽在冠心病严重程度及预后中的应用评价.DOCVIP

N-端B型钠尿肽前体在冠心病患者中的检测及对冠脉病变严重程度的评估意义 段伟 （宿州市第一人民医院 安徽 宿州 234000） 【摘要】目的 分析N-端B型脑尿肽前体(NT-proBNP)在稳定性心绞痛（SA）和急性冠脉综合征（ACS）患者中的血浆水平，评价及其和冠脉严重程度之间的关系。方法 选取我院2011年5月~2014年5月90例可疑SA和ACS的住院患者，所有患者行冠状动脉造影检查。在冠脉造影检查前留取血标本并用免疫定量分析法检测NT-proBNP水平，根据造影结果分为非冠心病组（50例）与冠心病组（45）例（SA 25例，ACS 20例），记录冠状动脉病变支数，通过Gensini评分，分析NT-proBNP与冠状动脉病变支数和狭窄程度关系。结果 ＳＡ和ＡＣＳ患者NT-proBNP水平明显高于非冠心病组，其中ACS患者明显高于SA患者，冠状动脉三支病变BNP水平＞二支病变＞一支病变，p＜0.05，差异具有统计学意义；基于Gensini积分三分位，将SA和ACS患者分为三组，三组进行比较，p＜0.05，差异具有统计学意义。结论 SA和ACS患者NT-proBNP水平升高，其对于SA和ＡＣＳ的诊断以及对冠脉病变严重程度的评估具有重要的临床意义。 【关键词】N-端B型脑钠肽前体；稳定性心绞痛；急性冠脉综合征 0bjective：To evaluate plasma N-terminal pro- B-type natriuretic peptide (NT-proBNP) levels ，and to study the relationship between the NT-proBNP levels and the severity of involed coronary vessels of patients with stable angina(SA) and acute coronary syndrome(ACS). Methods：90 patients suspected SA or ACS were recruited, All recruited patients underwent coronary angiographic examination(CAG).Blood samples for NT-proBNP were drawn before CAG and assayed by using immunological analysis.According to CAG result,they were classified into non- coronary artery disease group（n=45） and coronary artery disease group (SA group，n=25；ACS group，n=20). Record the number of coronary artery lesions and evaluate the severity of lesions by using Gensini score, to observe the major adverse cardiovascular event of patients by follow-up survey， and analyse the relationship between the NT-proBNP levels and the number and severity of involved coronary vessels.Results：A significant increase in NT-proBNP levels was observed in coronary artery disease group compared with non coronary artery disease group,ACS group had higher NT-proBNP levels than SA group. NT-proBNP levels in patients with 3-vessel disease2-vessel1-vessel. p＜0.05,the difference is statistically significant;Based on the tertile of the Gensini score,patients with SA and ACS were classified into the three groups ,three groups were compared, p＜0.05,the difference is statistical