摘要
目的观察不同临床类型冠心病病人的血浆脑钠肽(BNP)浓度的差异及其与心肌坏死标记物的相关性,并探讨其临床意义。方法90例经冠状动脉造影证实的冠心病病人,按临床类型分为急性心肌梗死(AMI)26 例,不稳定型心绞痛(UAP)38例,稳定型心绞痛(SAP)26例。28例非冠心病者作为对照组。检测AMI病人发病16 h以及其他研究对象入院时的血浆BNP浓度,同时定量测定AMI病人的肌钙蛋白T(TnT),根据生化检查、NYHA心功能分级以及超声检测排除症状性心功能不全及肾功能不全,比较不同组别BNP的差异以及AMI组BNP与TnT的相关性。结果AMI、UAP、SAP和对照组血浆BNP浓度分别为566 23±129 53 pg/mL、172 53±61 77 pg/mL、40 06±24 33 pg/mL、35 71±24 00 pg/mL,AMI组平均BNP明显高于UAP组(P<0 001),UAP组平均BNP明显高于SAP组和对照组(P<0 001),SAP组和对照组BNP无明显差异(P>0 05)。AMI组BNP与TnT高度相关( r=0 937,P<0 001)。结论不同临床类型冠心病病人的血浆BNP浓度存在差异,BNP可反映心肌坏死的程度。
Objective To explore the relationship between plasma level of B-type natriuretic peptide (BNP) and clinical phenotypes of coronary heart disease (CHD) and the correlation between BNP and troponin T(TnT). Methods 90 patients with CHD were enrolled in this study and 28 persons without CHD were selected the as control.Clinical phenotypes of CHD included acute myocardial infarction (AMI),unstable angina pectoris (UAP) and stable angina pectoris (SAP). Plasma levels of BNP were detected at 16 hours after the appearance of symptoms in AMI or on admission in other groups and its clinical significances were analyzed.Correlation between BNP and TnT which was detected at the same time with BNP was also analyzed in AMI group.Results Plasma level of BNP were 566.23±129.53 pg/mL, 172.53±61.77 pg/mL, 40.06±24.33 pg/mL and 35.71±24.00 pg/mL in the patients with AMI,UAP,SAP and control respectively.The level of BNP was significantly higher in AMI than that in other three groups (P<0.001,P<0.001,P<0.001);the level of BNP was significantly higher in UAP than that in SAP or control (P<0.001,P<0.001); there were no significant difference in BNP level between SAP and control (P>0.05).BNP level were highly correlated with TnT in AMI (r=0.937,P<0.001). Conclusion Plasma level of BNP are associated with clinical phenotypes of coronary heart disease and it may reflect degree of myocardial necrosis. [
出处
《中国急救医学》
CAS
CSCD
北大核心
2005年第4期253-254,共2页
Chinese Journal of Critical Care Medicine
关键词
冠心病
临床类型
B型脑钠肽
相关性
Coronary heart disease (CHD)
Clinical phenotype
B-type natriuretic peptide (BNP)
Correlation
