血浆NT-proBNP水平及胰岛素敏感性指标与不稳定型心绞痛危险分层相关研究  

Relationship between N-terminal pro brain natriuretic peptide and insulin sensitivity index in pa-tients with unstable angina pectoris

作　　者：王培[1] 郑晓晖[1] 胡丰朝[1] 杨睿[1] 

机构地区：[1]河南省濮阳市安阳地区医院心内二科, 安阳455000

出　　处：《中国实用医刊》2014年第17期15-17,共3页Chinese Journal of Practical Medicine

摘　　要：目的：检测不稳定型心绞痛（ UAP）患者血浆N端脑钠肽前体（ NT-proBNP）及胰岛素敏感性指标，探讨UAP患者血浆NT-proBNP及胰岛素敏感性指标[空腹血糖（ FBG）、空腹胰岛素（ FINS）、FINS/FBG及胰岛素敏感指数（ ISI）]变化及其相关临床意义。方法选取100例UAP患者为观察组，30例稳定型心绞痛（ SAP）患者作为对照组，30例健康体检者为正常对照（ COM ）组。UAP组据Braunwald UAP分级分为三组（1级组、2级组、3级组）。测定各组血浆NT-proBNP和胰岛素敏感性指标，分析结果并做直线相关分析。结果 UAP、SAP患者血浆NT-proB-NP、FINS FINS/FBG均明显高于COM组（P﹤0.05），而ISI均明显低于COM组（P﹤0.05）；UAP患者NT-proBNP、FINS、FINS/FBG均高于SAP患者（P﹤0.05），而ISI明显低于SAP组（P﹤0.05）；各组间FBG比较差异无统计学意义；Braunwald UAP分级2级、3级组患者血浆NT-proBNP、FINS、FINS/FBG均明显高于1级组（ P﹤0.05），而ISI明显低于1级组（ P﹤0.05）。2级、3级组患者血浆NT-proBNP、FINS、FINS/FBG及ISI组间比较差异均无统计学意义；UAP患者的血浆NT-proBNP浓度与FINS、FINS/FBG呈正相关（ r=0.38，P=0.046，r=0.56，P=0.039），与ISI呈负相关（r=-0.62，P=0.028），与FBG无相关性。结论 UAP患者的血浆NT-proBNP升高，胰岛素敏感性降低，在Braunwald UA分级2级、3级（静息性心绞痛）更明显，NT-proBNP浓度与胰岛素敏感性呈负相关，其联合测定对UAP的危险分层有意义。Objective To study the correlation of N-terminal pro brain natriuretic peptide（ NT-proBNP）with insulin sensitivity index（ FBG,FINS,FINS/FBG,ISI）in UAP patients,and its clinical significance. Methods One hundred patients with UAP were enrolled as the observation group,30 patients with stable angina pectoris（ SAP）as SAP group,and 30 healthy people as the normal control （COM）group. According to the Braunwald UAP,patients in UAP group were graded into 3 supgroups（ grade 1 ,grade 2 and grade 3 ）. The plasma NT-proBNP and insulin sensitivity indexes were detected in each group,and then the results were analyzed and the linear correlation analysis was made. Results The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP and SAP group were significantly higher than those in COM group（ P﹤0. 05 ）,but ISI was lower than that in COM group（ P ﹤0. 05 ）. The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP were significantly higher than those in patients with SAP（ P﹤0. 05 ）,but ISI was lower than that in patients with SAP（P﹤0. 05）,and there was no significant difference in FBG between the two groups. The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with grade 2 and grade 3 were significantly higher than those in patients with grade 1（ P﹤0. 05 ）,but ISI was lower in the grade 2（ P﹤0. 05）. No significant diference was found between grade 2 and grade 3. In UAP patients,the plasma NT-proBNP concentration was positively correlated with FINS,FINS/FBG（ r =0. 38,P =0. 046,r =0. 56 ,P=0. 039 ）,and negative correlated with ISI（ r = -0. 62 ,P =0. 028 ）,and with no correlation with FBG. Conclusions The concentration of plasma NT-proBNP was elevated and insulin sensitivity decreased in UAP, especially in Braunwald UAP grade 2 and grade 3（ rest angina ）,the concentration of NT-proBNP was negatively correlated with insulin sensitivity. The combined determination is significant in risk grading reference of UAP.

关 键 词：不稳定型心绞痛 血浆N端脑钠肽前体 胰岛素敏感性指标 

分 类 号：R541.4[医药卫生—心血管疾病]