80岁以上老年冠心病患者心肌损伤程度与血浆NT-proBNP水平关系的临床研究  

Study of relationship between degree of mycardial injury and serum amino-terminal Pro-B type natriuretic peptide level in patients aged 80 and over with coronary heart disease

作　　者：朱启伟[1] 高鹏[1] 张今尧[1] 曹瑞华[1] 白永怿[1] 骆雷鸣[1] 

机构地区：[1]中国人民解放军总医院南楼心血管内二科,北京市100853

出　　处：《实用老年医学》2013年第5期427-430,共4页Practical Geriatrics

摘　　要：目的探讨不同的诊断依据与≥80岁老年冠心病患者血浆氮末端脑利钠肽前体(amino-terminal pro-B type natriuretic peptide,NT-proBNP)水平的关系,评估症状及普通心电图等诊断手段对冠脉病变的诊断价值。方法将2008年4月至2010年9月在解放军总医院老年病房住院的≥80岁、有冠心病病史的患者,按照冠心病诊断方式分为冠心病1组(有冠脉造影、急性心肌梗死或冠脉旁路移植术史)、冠心病2组(经症状及普通心电图诊断),另入选同期住院,年龄、性别相匹配的无冠心病病史的患者(对照组),检测其血浆NT-proBNP水平。结果冠心病1组血浆NT-proBNP显著高于冠心病2组和对照组,冠心病2组显著高于对照组。结论心肌缺血坏死、损伤后对心功能造成长期、持续的影响;症状发作时普通心电图有缺血改变依然是诊断冠心病的可靠依据。Objective To investigate the relationship between different methods of diagnosis and serum amino-terminal Pro-B type natriuretic peptide(NT-proBNP) level in patients aged 80 and over with coronary heart disease(CHD),and to evaluate diagnostic value of symptoms and general electrocardiogram to CHD.Methods 409 patients aged 80 and over admitted in geriatric ward from April 2008 to September 2012 were divided into two groups according to the methods of diagnosis.CHD group one included the patients who had history of acute myocardial infarction,coronary artery bypass graft,or had one main artery stenosis over 70%.CHD group two included the patients who had typical or non-typical chest distress(diagnosed with abnormal ECG).124 patients without CHD were selected as control group.The levels of serum NT-proBNP,serum creatine and haemoglobin were detected and compared.Results Compared with CHD group two or control group,serum NT-proBNP level in CHD group one was significantly higher(P<0.01).Serum NT-proBNP level of CHD group two was higher than that of control group(P<0.05).Conclusions Myocardial ischemia has long-term and continuous effects on heart funtion.The features of ischemia in ECG is a reliable evidence for the diagnosis of CHD when the symptoms are on-set.

关 键 词：老年人 冠心病 氮末端脑利钠肽前体 

分 类 号：R541.4[医药卫生—心血管疾病]