冠心病患者血浆脑钠肽、超敏C反应蛋白水平的变化及与冠脉病变关系的研究  

Relationship between coronary pathological changes and changes of BNP,hsCRP in the patients with different clinical phenotypes of coronary heart disease

作　　者：程华[1] 胡志鹏[1] 

机构地区：[1]宁夏医科大学附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2011年第4期301-303,共3页Ningxia Medical Journal

摘　　要：目的观察不同类型冠心病患者的血浆脑钠肽(BNP)和超敏C反应蛋白(hsCRP)水平的变化及与冠脉病变之间的关系,探讨其临床意义。方法 101例均经冠状动脉造影确诊的冠心病(CHD)患者,按临床类型分为急性心肌梗死(AM I)组36例,不稳定型心绞痛(UAP)组34例,稳定型心绞痛(SAP)组31例;另选30例非CHD者作对照组。根据冠状动脉病变的范围分为单支血管病变组(31例)、双支血管病变组(48例)和三支血管病变组(22例),均于入院时测定血清中BNP、hsCRP水平,并进行统计学分析。结果 AM I组血浆BNP、及hsCRP水平明显高于UAP组(P<0.05),UAP组各项指标明显高于SAP组和对照组(P<0.05),SAP组与对照组各项指标水平比较差异均无统计学意义(P>0.05)。BNP与hsCRP水平变化呈正相关,与左室射血分数呈负相关,三支病变组较单支、双支病变组BNP水平差异有统计学意义。结论不同临床类型CHD患者的血浆BNP、hsCRP水平不同,提示上述指标对CHD患者进行危险分层及分析预后有一定临床价值。血清BNP水平水平的增高对冠心病患者病变累及的程度可能有一定临床参考价值,且BNP是较CRP更敏感的指标。Objective To observed the changes of plasma levels of BNP,hsCRP in patients with different types of coronary heart disease and investigate its clinical value.And to investigate the relationship between their concentration variances and coronary angiography disease.Methods The total of 101 patients with CHD diagnosed by selected coronary angioplasty were enrolled in this study,including 36 cases with acute myocardial infarction（AMI）,34 cases of unstable angina（UAP） and 31 cases of stable angina（SA）.And 30 persons without CHD were selected as the control.According to the scope of coronary artery disease,the CHD group was divided into single vessel disease group（31 cases）,double vessel disease group（58 cases） and three vessel disease group（22 cases）.All cases were respectively measured serum BNP and hsCRP levels on admission,then analyzed.Results Plasma levels of BNP and hsCRP in AMI group were obviously higher than those in UAP group（P0.05）.All markers in UAP group were obviously higher than those in SAP group（P0.05）.There were no significant differences of these markers between SAP group and control group.Plasma BNP levels were positively correlated with plasma hsCRP levels and negatively correlated with LVEF.Levels of serum BNP of three lesions are higher than the single vessel disease group and double vessel disease group.Conclusion Plasma levels of BNP,hsCRP are associated with different clinical phenotyes of CHD.Their levels increased in CHD patients may have some degree of clinical reference value for lesions involving the extent of coronary artery,and BNP is a more sensitive indicator than CRP.

关 键 词：冠心病 脑钠肽 超敏C反应蛋白 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]