急性心肌梗死血清白蛋白与B型钠尿肽和超敏C反应蛋白及左心室射血分数的相关性  

Relationship of serum albumin with BNP, hs-CRP and LVEF in patients with acute myocardial infarction

作　　者：邓次妮[1] 雷健[1] 

机构地区：[1]湖北省武汉市第一医院心血管内科,430022

出　　处：《中国综合临床》2012年第8期838-841,共4页Clinical Medicine of China

摘　　要：目的探讨急性心肌梗死（AMI）患者血清白蛋白与B型钠尿肽（BNP）、超敏C反应蛋白（hs—CRP）及左心室射血分数之间的相关性。方法测定95例AMI患者（AMI组）的血清白蛋白、BNP及hs—CRP浓度；并行超声心动图检查，采用Simpson法测定左心室射血分数。另外选取50例非冠心病老年患者作为正常对照组。依血清白蛋白水平不同将AMI患者分为正常血清白蛋白组（74例）和低血清白蛋白组（21例）两个亚组。结果AMI组血清白蛋白为（38．45±4．60）g／L，低于对照组（43．15±3．11）g／L，差异有统计学意义（t=8．53，P〈0．001），低血清白蛋白组BNP[（5．24±1．71）ng／L]显著高于正常血清白蛋白组[（4．17±1．61）ng／L]，差异有统计学意义（t=2．660，P=0．009），低血清白蛋白组hs—CRP[（1．64±0．93）mg／L]显著高于正常血清白蛋白组[（1．13±1．03）mg／L]，差异有统计学意义（t=2．159，P=0．045），低血清白蛋白组左心室射血分数（49．10±11．63）％显著低于正常白蛋白组（54．63±9．60）％，差异有统计学意义（t=2．268，P=0．025）。AMI患者血清白蛋白与BNP呈负相关（r=-0．465，P〈0．001），与hs-CRP呈负相关（r=-0．391，P〈0．001）；hs—CRP与BNP呈正相关，（r=0．492，P〈0．001），BNP与左心室射血分数呈负相关（r=-0．371，P〈0．001）。结论血清白蛋白浓度变化可作为评价急性心肌梗死患者预后的指标。Objective To study the changes of serum albumin and its relationship with B-Type Natriuretic Peptide （BNP）, High sensitivity C-reactive protein （hs-CRP）and left ventricular ejection fraction （LVEF） in patients with acute myocardial infarction （AMI）. Methods Serum levels of albumin, BNP, hs-CRP at baseline were analyzed in 95 patients with AMI, and LVEF were measured by echocardiography. All AMI patients were divided into 2 groups based on the values of serum albumin ： the hypoalbuminemia group and the normal albuminemia group. Fifty patients without coronary artery disease were selected as controls. The correlations between serum albumin and BNP, hs-CRP, LVEF were analyzed. Results Serum albumin in AMI patients was lower than that in the controls [ （ 38.45 ± 4.60） g/L vs. （43. 15 ± 3.11 ） g/L; t = 8. 53, P 〈 0. 001 ] . BNP and hs-CRP levels in the hypoalbuminemia group were higher than that in the normal albuminemia group [ （5.24 ± 1.71）ng/L vs. （4. 17 ± 1.61）ng/L;t =2. 660,P =0.009;（1.64 ±0.93） mg/L vs. （1.13 ±1.03） mg/L;t =2. 159 ,P =0. 045]. LVEF in hypoalbuminemia group was lower than that in the normal albuminemia group [ （ 49. 10 ± 11.63 ） % vs. （ 54. 63 ± 9.60 ） % ; t = 2. 268, P = 0. 025 ]. Levels of serum albumin were negatively correlated with BNP and hs-CRP in AMI patients（ r = - 0. 465 ,P 〈 0. 001 ; r = - 0. 391 ,P 〈 0. 001 ） . Levels of BNP were positively correlated with hs-CRP（ r =0. 492 ,P 〈 0. 001 ）. LVEF was negatively correlated with BNP values （r = -0. 371, P 〈 0. 001 ）. Conclusion Hypoalbuminemia is associated with the prognosis of AMI and may be an important predictor of adverse outcome in patients with it.

关 键 词：急性心肌梗死 血清白蛋白 超敏C反应蛋白 B型钠尿肽 左心室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]