不同类型冠心病患者血浆B型钠尿肽水平的变化及其临床意义  

Levels of plasma B-type natriuretic peptide and its significance among different clinical phenotypes of coronary heart disease

作　　者：滕玲[1] 佴玉[1] 杨成[1] 

机构地区：[1]浙江省台州医院,台州318050

出　　处：《临床医学》2006年第2期17-19,共3页Clinical Medicine

摘　　要：目的观察不同类型冠心病患者血浆B型钠尿肽(BNP)浓度的改变及其与左心室射血分数(LVEF)的相关性,并探讨其临床意义。方法把经冠状动脉造影证实为冠心病的患者112例作为观察对象,按临床类型分为:急性心肌梗死(AM I)组(38例),不稳定型心绞痛(UAP)组(50例),稳定型心绞痛(SAP)组(24例);对照组为非冠心病患者22例。采用双抗夹心免疫荧光法测定血浆B型钠尿肽(BNP)浓度,并行超声心动图检查评价心功能。比较不同组BNP浓度的差异以及各组BNP水平与LVEF的相关性,并观察AM I组心血管事件发生者与未发生者血浆BNP浓度的差异。结果AM I组BNP水平明显高于UAP、SAP和对照组(P<0.01),UAP组BNP水平明显高于SAP组和对照组(P<0.01),SAP和对照组BNP水平无明显差异(P>0.05)。AM I组和UAP组LVEF与血浆BNP水平均呈明显负相关,AM I组发生心血管事件的患者血浆BNP浓度明显高于未发生者(P<0.05)。结论不同类型冠心病患者血浆BNP浓度存在差异,血浆BNP浓度与LVEF有明显的负相关,血浆BNP浓度可预测AM I近期预后。Objective To explore the relationship between levels of plasma B -type natriuretic peptide （BNP）and clinical phenotypes of coronary heart disease（CHD） and the correlation between BNP concentrations and left ventricular ejection function （LVEF）. Methods One hundred and twelve patients with CHD were enrolled in this study including 38 patients with actue myocardial infarction（AMI） ,50 patients with Vnstable angina pectoris（ UAP）, and 24 patients with stable angina pectoris（ SAP）, and 22 persons without CHD as controlgroup. Plasma BNP concentrations were measured and echocardiongrants were detected in all patients to measure LVEF. Correlation between BNP conlentrations and LVEF was also analyzed in every groups. The main outcome measured were heart failure,left romodeliy,mortality and other adverse cardiac events in AMI group. Results Plasma BNP concentrations increased in patients with AMI compared with UAP,SAP and control subjects. The levels of BNP were significantly higher in AMI than that in other three groups（ P 〈0.01 ） ,and the level of BNP was significantly higher in UAP than that in SAP or control group（ P 〈0.01 ）. There were no significant difference in BNP level between SAP and control group（ P 〉0. 05）. Plasma BNP concentrations correlated with LVEF in patients with AMI and UAP. The level of BNP was significantly higher in the patients with heart failure than that with no heart failure in AMI group（ P 〈 0. 05 ）. Conclusion Plasma levels of BNP are associated with clinical phenotypes of coronary heart disease. It could serve as a strong predictor for the subsequent development of poor outcome in patients with AMI.

关 键 词：冠心病 B型钠尿肽 相关性 预后 

分 类 号：R541.4[医药卫生—心血管疾病]