摘要
目的通过测定冠心病患者介入治疗前后血浆脑钠肽前体N-末端片段(NT-proBNP)水平的变化,探讨冠状动脉介入治疗(PCI)对老年冠心病患者血浆NT-proBNP及高敏C反应蛋白(Hs-CRP)水平的影响。方法冠心病介入治疗组(PCI组)24例和单纯冠脉造影组(CAG组)30例,在术前、术后即刻、1h、24h以及72h分别测定血浆NT-proBNP及Hs-CRP水平。结果术前PCI组与CAG组的NT-proBNP水平差异无统计学意义。CAG组术前和术后NT-proBNP水平无显著变化。PCI组术后血浆NT-proBNP水平比术前明显升高,从术前的231.31±233.52pg/mL逐渐升高,至术后24h达到峰值663.75±614.93pg/mL,与术前相比差异具有统计学意义(P<0.05)。术后即刻、术后1h、24h和72h4个时间点PCI和CAG两组之间的差异均具有统计学意义。两组患者的Hs-CRP水平在术后72h较术前明显升高。结论PCI导致的短暂心肌缺血可引起血浆NT-proBNP水平升高,提示NT-proBNP可作为心肌缺血的监测指标并有助于老年人不典型心肌缺血的诊断。PCI及CAG术后72hHs-CRP升高,提示Hs-CRP与血管急性损伤所致炎症反应有关。
Objective To evaluate the influence of pereutaneous coronary intervention (PCI) on NT- proBNP and Hs-CRP level of the elderly with coronary heart disease. Methods Twenty-four patients who underwent PCI, and thirty patients who underwent coronary angiography (CAG) were enrolled in this study. Plasma NT-proBNP and Hs-CRP concentrations before and at 0, 1 h, 24 h and 72 h after PCI were assayed in all patients. Results There were no significant difference in plasma NT-proBNP level at baseline level between the and CAG group, and also no signitieant change in the CAG group after the procedure. Plasma NT-proBNP level was increased signifieantly from 231.31 ± 233.52 pg/mL to the peak concentration of 663.75 ± 614.93 pg/mL at 24 h after PCI. Statistical differences were observed between the baseline levels and at 24 h as well as 72 h after the operation in the PCI group. Plasma NT-proBNP concentrations also showed significant differences between the PCI and CAG group at each time point after the procedures. Remarkable elevation in plasma Hs-CRP level was observed at 72 h after procedure in all patients. Conclusion Elevation of plasma NT-proBNP eoneontrations might be induced by transient myocardial iscbemia in PCI. NT-proBNP may be a marker of myocardial ischemia and may be useful to detect untypical ischemia in the elderly. Plasma Hs-CRP increased at 72 h after PCI and CAG, which may be related to inflammation reaction induced by vessel puncture.
出处
《中国介入心脏病学杂志》
2006年第6期331-334,共4页
Chinese Journal of Interventional Cardiology
关键词
血管成形术
经腔
经皮冠状动脉
冠状动脉疾病
利钠肽
脑
C反应蛋白质
Argioplasty, tmnsluminal, percutaneous coronary
Coronary disease
Natriuretie peptide, brain
C-reactive protein