摘要
目的探讨脑钠肽（BNP）与2型糖尿病患者的心血管危险因素的关系、BNP水平与糖尿病患者合并冠心病的严重程度及其近期预后的关系，探寻一种评价2型糖尿病患者心血管危险的方法。方法以154例2型糖尿病患者作为研究对象，其中合并原发性高血压65例，合并冠心病95例。合并冠心病者按临床类型分为稳定型心绞痛组30例、不稳定型心绞痛组33例、急性心肌梗死组32例。观察入选患者的BNP水平和各种心血管危险因素的关系；对合并冠心病者，观察BNP水平和冠心病不同类型之间的关系，随访6个月观察BNP对合并冠心痛患者死亡的预测作用。结果入选患者的BNP平均为（397．34±217．79）ng／L，2型糖尿病患者的BNP水平与患者的年龄、CRP、高血压及冠心痛正相关（Spearman等级相关指数分别为0．631、0．672、0．762、0．857，P均〈0．05）；2型糖尿病患者BNP水平随患者年龄升高而升高（r=0．896，P〈0．01）：〈50岁组（57．6±12．3）ng／L，50—59岁组（146．2±53．4）ng／L，60—69岁组（388．4±67．5）ng／L，≥70岁组（423．8±132．6）ng／L（P〈0．01或P〈0．05）；2型糖尿病患者合并原发性高血压者较无高血压合并症者BNP明显升高[（314．7±125．3）ng／L与（136．8±98．7）ng／L，P〈0．01]；合并冠心病的患者BNP高于无冠心病合并症的患者[（425．03±200．80）ng／L与（37．64±21．57）ng／L，P〈0．01]，合并冠心病BNP水平与近期预后关系密切，BNP浓度≥485ng／L为1个月内心源性死亡的独立预测因素。结论糖尿病患者的BNP水平和患者的心血管危险相关，对合并冠心病者BNP可作为预测心血管危险的指标。
Objective To explore the relationship of plasma level of B-type natriuretic peptide （BNP） with cardiovascular risk, the severity of coronary heart disease （ CHD）, and the short-term prognosis in patients with type 2 diabetes. Methods 154 patients with type 2 diabetes,of them 95 eases complicated with CHD and 65 with hypertension were selected in this study. The CHD patients were diveded into 3 groups ： AMI （ n = 32）, UAP（ n = 33 ） and SAP（n =30）. The relationship of the plasma BNP levels with cardiovascular risks,with each coronary heart diseases, were observed. The patients were followed up for 6 months to study the predicting role of BNP on the death in patients accompanied with CHD. Results The plasma BNP level was（ 397.34 ± 217.79）ng/L, which was correlated with age, C RP, hypertension and CHD （ r = 0. 631,0.672,0.762,0.857, P 〈 0.05 for each ） ; the plasma BNP levels increased with age （ r = 0. 896,P 〈 0. 01 ） ： （ 57.6 ± 12.3 ） ng/L in patients 〈 50 years old, （ 146.2 ± 53.4） ng/L in patients 50 ≤ and 〈 59 years old, （ 388.4 ± 67.5 ） ng,/ in patients 60 ≤and 〈 69 years old, and （ 423.8 ± 132.6 ） ng/L in patients ≥70 years old（ P 〈0. 01 or P 〈0.05 ）. The plasma BNP levels ,was higher in patients with hypertension than that in patients without hypertension[ （ 314.7 ± 125.3 ） ng/L vs（ 136.8 ± 98.7 ） ng/L, P 〈 0.01 ] ; Higher in patients with CHD than that in patients without CHD [ （425.03 ±200.80） ng/L vs（37.64 ±21.57） ng/L,P 〈0.01 ）]. The short-term prognosis of patients with CHD was correlated with the levels of BNP,and BNP levels ≥485 ng/L may be an independent predicting factor for cardiac death within one month. Conclusions Plasma levels of BNP were associated with some cardiovascular risks,which may be one of biomarkers for cardiovascular risks in patient complicated with CHD.
出处
《中国综合临床》
2009年第11期1144-1148,共5页
Clinical Medicine of China
关键词
冠心病
2型糖尿病
脑钠肽
Coronary heart disease
Type 2 diabetes
B-type natriuretic peptide
