血浆B型钠尿肽在急性非ST段抬高型冠脉综合征预后预测的临床应用及与炎症因子的相关性研究  

Predicting Significance of BNP in Acute non-ST Segment Elevation Coronary Syndrome and Its Relationship with CRP

作　　者：李亚[1] 耿涛[1] 彭万忠[1] 徐泽升[1] 

机构地区：[1]河北省沧州市中心医院心血管内科,061001

出　　处：《中国全科医学》2010年第31期3523-3525,共3页Chinese General Practice

摘　　要：目的研究BNP在急性非ST段抬高型冠脉综合征(NSTE-ACS)预后预测的临床应用及与炎症因子超敏C反应蛋白(hs-CRP)的相关性研究。方法选择2009—2010年我院收治的NSTE-ACS患者245例,入院后测hs-CRP和BNP,根据BNP水平分为A组BNP>100pg/ml(86例),B组BNP<100pg/ml(159例)。均行冠脉造影,根据具体情况分别行冠脉介入治疗、冠脉搭桥手术及药物保守治疗,比较两组患者一般资料、冠脉病变特点、支架置入情况、具体治疗情况,以及临床6个月随访中死亡、再发心肌梗死、再次血运重建术等情况。结果 A组肌钙蛋白I阳性率高于B组;A组hs-CRP水平与B组比较差异有统计学意义(P<0.05);冠脉造影结果显示,A组单支病变患者10例,B组单支病变患者82例,两组比较差异有统计学意义(P<0.05);两组三支病变发生情况比较差异亦有统计学意义(P<0.01);A组左主干病变发生率明显高于B组,差异有统计学意义(P<0.05);两组行冠脉介入治疗植入支架总数目比较差异有统计学意义(P<0.05);A组行冠脉搭桥手术7例,B组4例,两组比较差异有统计学意义(P<0.05);随访6个月主要心脏事件发生A组明显高于B组,差异有统计学意义(P<0.05)。BNP与肌钙蛋白I、hs-CRP水平均呈正相关。结论 BNP升高与NSTE-ACS患者严重冠脉病变、三支病变、左主干病变、死亡率高、临床预后差有密切关系,并且与hs-CRP显著相关。Objective To investigate the predicting significance of B-type natriuretic peptide （BNP） in acute non-ST segment elevation coronary syndrome （NSTE-ACS） and its relationship with high-sensitive C-reactive protein （hs-CRP）.Methods Totally 245 NSTE-ACS inpatients who had hospitalized from 2009 to 2010 in our hospital were given CRP and BNP tests after hospitalization.And they were divided according to the level of BNP into two groups.The patients whose BNP〈100pg/m were in group A （n=86）,and the whose BNP〈100 pg/ml were in group B （n=159）.All patients accepted coronary artery angiography （CAG） and,according the CAG results,were selected percutaneous coronary intervention （PCI） or coronary artery bypass surgery （CABG） or drug treatment.All the conditions of patients between the two groups as well as the deaths,reoccurrence of myocardial infarction and revascularization during the 6-month follow-up were compared.Results The troponin I positive rate of group A was significantly higher than that of group B,and the hs-CRP level of group A was also significantly higher than that of group B （P〈0.05）.CAG showed that single coronary artery lesion was found in 10 patients in group A 82 patients in group B （P〈0.05）.And there was also statistical difference in three-vessel coronary lesions between the two groups （P〈0.01）.The rate of left main artery lesion in group A was obviously higher than that in group B （P〈0.05）.The total number of stents implanted in group A was obviously more than that in group B （P〈0.05）.CABG was conducted for 7 patients in group A but for 4 patients in group B （P〈0.05）.During the 6-month follow-up,the major adverse events occurred was significantly more in group A than in group B （P〈0.05）.Linear correlation analysis demonstrated that BNP was positively correlated with troponin I and hs-CRP.Conclusion In NSTE-ACS patient,BNP was significantly associated with left main or 3-vessel coronary lesions,higher heath rate,and poor prog

关 键 词：B型钠尿肽 超敏C反应蛋白 急性非ST段抬高型冠脉综合征 冠脉介入治疗 肌钙蛋白I 冠脉搭桥手术 主要心脏事件 

分 类 号：R540.49[医药卫生—心血管疾病]