脑钠尿肽与冠状动脉病变严重程度的相关性研究  

Study of relationship between plasma brain natriuretic peptide and severity of coronary artery disease

作　　者：贾永平[1] 王凤群[1] 吕吉元[1] 高宇平[1] 王睿[1] 郭志萍 刘春花[1] 

机构地区：[1]山西医科大学第一医院心内科,山西太原030027

出　　处：《中国民康医学》2005年第11期647-649,653,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨脑钠尿肽(Brain natriuretic peptide BNP)水平与冠状动脉病变严重程度的关系. 方法: 对156例入选病例均行冠状动脉造影术,其中男103例,女53例,年龄33～81岁,平均(59.15±10.60)岁.冠状动脉病变的严重程度用病变的血管支数及Gensini积分表示.所有病例均在术前、术后测量仰卧位肱动脉血压,记录收缩压(SBP)和舒张压(DBP)平均值,PP=SBP﹣DBP.所有患者均于术前清晨抽取2ml肘静脉血,用免疫放射方法(IMRA)测量BNP值.结果:高血压组较非高血压组冠心病患病率明显增高(76.9%比61.5%,P=0.038).高血压组患者冠脉三支血管病变的患病率显著高于非高血压组(35.2%比12.3%,P=0.001).高血压组血浆BNP浓度显著高于非高血压组(P=0.007).冠脉狭窄组, 无论肱动脉测压、其SBP、PP均显著高于冠脉正常组,有显著差异(P<0.05),且SBP与PP随着冠脉血管狭窄支数的增加而逐渐增加.冠状动脉单支、双支、三支病变组,血浆BNP值均显著高于冠状动脉正常组,有显著差异(P<0.001).多因素分析结果显示肱动脉PP 、BNP、年龄与冠心病冠脉狭窄程度的关系最为密切.结论:PP是冠心病冠脉狭窄发生发展的独立危险因素,BNP与PP密切相关,BNP可以作为预测冠心病冠状动脉狭窄程度的血浆标志物.Objective： To evaluate the relationship between plasma brain natriuretic petide （BNP） and the severity of coronary artery stenosis. Methods：One hundred and fifty -six patients were enrolled, All patients underwent coronary angiography, 53 female patients, mean age 33 - 81 （59.15 ＋ 10.60）years old. The severity of coronary artery lesions was evaluated by the number of disease arteries and Gensine score. Brachial systolic blood pressure （SBP） and diastolic blood pressure （DBP） were measured before and after coronary angiography. Blood samples were taken for measurement of BNP before coronary angiography. Results： Patients with essential hypertension had higher incidence of coronary heart disease （76.9% vs 61.5 %, P = 0. 038 ） than those without essential hypertension. Patients with essential hypertension had higher incidence of 3 coronary artery disease （35.2% vs 12.3 % , P = 0. 001 ） than those without essential hypertension. Median plasma BNP concentratrations in Patients with essential hypertension was significantly higher than in those without essential hypertension （ P =0. 007 ）. They were all significantly higher in patients with coronary artery disease than in the normal subjects for Brachial SBP and PP. Median plasma BNP concentratrations in Patients with coronary artery disease was significantly higher than in the normal subjects. Multiple regression analysis indicated that Brachial PP, BNP and age were closely related to the severity of coronary lesions. Conclusions： PP was an independent risk factor of the severity of coronary artery stenosis, Plasma BNP concentratrations is closely related to PP, which might be a plasma marker of the predictors of severity of coronary artery disease.

关 键 词：脉压 脑钠尿肽 冠状动脉疾病 

分 类 号：R977.1[医药卫生—药品] R541.4[医药卫生—药学]