冠心病经皮冠脉介入治疗患者N末端脑钠肽前体水平与冠脉病变严重程度的相关性研究  

Correlation between Plasma NT-proBNP Value and Severity of Coronary Artery Diseases in Percutaneous Coronary Intervention Patients

作　　者：刘雅[1] 刘阔[1] 楼煜清[1] 刘洁琳[1] 王佐广[1] 文杰[1] 严山[1] 牛秋丽[1] 顾伟[1] 李志忠[2] 温绍君[1] 

机构地区：[1]首都医科大学附属北京安贞医院,北京市心肺血管疾病研究所高血压研究室,北京市100029 [2]首都医科大学附属北京安贞医院心内科

出　　处：《中国全科医学》2011年第16期1785-1788,共4页Chinese General Practice

基　　金：国家科技支撑计划(2008BAI52B03);国家高技术研究发展计划(863计划)(2008AA02Z441)

摘　　要：目的研究冠心病经皮冠脉介入治疗(PCI)者N末端脑钠肽前体(NT-proBNP)水平与冠脉病变严重程度是否相关,探讨NT-proBNP作为冠心病疾病严重程度客观生化指标的临床意义。方法顺序入选因冠心病行冠状动脉造影且行NT-proBNP检测的患者844例,按照冠状动脉狭窄Gensini积分、不同冠状动脉病变和不同梗死相关血管进行分组,采用方差分析和2χ检验等分析对比各组间NT-proBNP水平和心功能相关指标的差异。结果随着病变支数的增加,NT-proBNP水平升高,左房直径增大,左室射血分数(LVEF)减低;随着Gensini积分的增加,NT-proBNP水平、患者年龄和左室舒张末径(LVEDd)升高,LVEF降低,差异均有统计学意义(P<0.05)。NT-proBNP与年龄、左房直径、LVEDd、Gensini积分、病变支数呈正相关,与LVEF呈负相关(P<0.01)。结论冠心病患者NT-proBNP水平与疾病的严重程度有一定的相关性,NT-proBNP可能会成为冠心病严重程度的生化指标之一。Objective To investigate the correlation of plasma concentration of N-terminal-pro-brain natriuretic peptide（NT-proBNP） in patients with coronary artery disease（CAD） received percutaneous coronary intervention（PCI） with severity of the diseases,and whether NT-proBNP is a reliable biochemical marker to correctly indicate the severity of CAD.Methods Totally 844 patients who underwent PCI because of coronary heart disease were consecutively recruited.Their plasma NT-proBNP level was determined.The patients were further divided into various subgroups according to Gensini score,coronary arteries involved,and infarction related arteries（IRA）.The results of plasma NT-proBNP and related indices of cardiac function were analyzed by using Analysis of Variance and χ~2 test.Results As the number of coronary arteries involved increased,NT-proBNP level and left atrial diameter increased,and left ventricular ejection fraction（LVEF） decreased;and with the increase of Gensini score,NT-proBNP levels,patient age and left ventricular end-diastolic volume（LVEDd） increased,ejection fraction（LVEF） reduced（P〈0.05）.NT-proBNP level was positively correlated with age,left atrial diameter,LVED,Gensini score,and number of coronary arteries involved,and negatively correlated with LVEF（P〈0.01）.Conclusion Plasma concentration of NT-proBNP in patients with CAD is of a certain correlation with the severity of the disease,which might be one of the biochemical markers indicating the severity of the disease.

关 键 词：冠心病 N末端脑钠肽前体 血管成形术 经腔 经皮冠状动脉 

分 类 号：R514[医药卫生—内科学]