BNP和冠状动脉病变及心脏变时性相关性研究.docVIP

BNP和冠状动脉病变及心脏变时性相关性研究 　　[摘要]目的探讨冠心病患者血浆脑钠肽（BNP）与冠状动脉病变严重程度及心脏变时性的相关性。方法记录冠心病患者血浆BNP水平及心脏变时性指标，包括rHR和HRR，并记录冠状动脉造影（CAG）结果，计算Gensini评分，对比分析无症状性心肌缺血、稳定型心绞痛及不稳定型心绞痛3组患者血浆BNP水平及心脏变时性指标差异。评价血浆BNP水平与冠状动脉病变严重程度及心脏变时性指标相关性。结果本研究共纳入462例冠心病患者，单因素方差分析结果显示各组间BNP水平差异均有统计学意义（均P0.05）；无症状性心肌缺血与不稳定型心绞痛心脏变时性指标rHR比较差异有统计学意义（P0.05）。Person相关分析显示，冠心病患者血浆BNP水平与冠状动脉病变Gensini评分呈正相关（r=0.43，P0.05），与心脏变时性指标rHR及HRR均呈负相关（r=-0.34，-0.40，均P0.05）。结论冠心病患者血浆BNP与冠状动脉病变程度及心脏变时性指标rHR和HRR密切相关，对于评价冠心病心脏功能的改变有重要的临床价值。 　　[关键词]冠心病；脑钠肽；心脏变时性 　　中图分类号：R541.4文献标识码：A文章编号：1009_816X（2014）06_0470_04 　　[Abstract] Objective To investigate the correlation of degree of coronary artery lesion and chronotropic response in patients with coronary heart disease. Methods BNP and chronotropic response including rHR and HRR were recorded of patients with coronary heart disease， outcomes of coronary angiography （CAG） and the score of Gensini were also recorded. Contrastive analysis of BNP and chronotropic response of three groups， myocardial ischemia， stable angina pectoris （SAP） and unstable angina pectoris （UAP）， were taken and the correlation of degree of coronary artery lesion and chronotropic response was evaluated. Results A total of 462 patients with coronary heart disease were enrolled. Analysis of Variance showed there were significant differences of the level of BNP among the three groups （all P0.05）. There were significant differences of rHR between the group of myocardial ischemia and UAP （P0.05）. There was positive correlation between BNP and the score of Gensini （r=0.43，P0.05）. There was negative correlations between BNP and rHR， so did BNP and HRR （r=-0.34，-0.40， all P0.05）. Conclusions BNP， rHR， HRR， and degree of coronary artery lesion are closely related and valuable for the evaluation of cardiac function in patients with coronary heart disease. 　　[Key words] Coronary disease； Brain natriuretic peptide； Chronotropic response 　　脑钠肽（brain natriuretic peptide，BNP）又称B型利钠肽（B_type natriuretic peptide），是利尿肽家族中最为重