不稳定型心绞痛患者N-末端脑钠肽前体浓度与肌钙蛋白I的相关性研究  

Correlation between plasma level of brain natriuretic peptide and cardiac troponinI in patients with Unstable angina pectoris

作　　者：阿布力米提.米吉提 

机构地区：[1]和田地区医院心内一科,新疆维吾尔自治区848000

出　　处：《实用老年医学》2014年第12期1030-1032,1035,共4页Practical Geriatrics

摘　　要：目的探讨在心功能正常情况下不稳定型心绞痛(unstable angina pectoris,UAP)与稳定型心绞痛(stable angina pectoris,SAP)患者血浆N-末端脑钠肽前体(NT-proBNP)浓度的差异及UAP患者血浆NT-proBNP浓度与肌钙蛋白I(cTnI)的相关性及其临床意义。方法选择住院冠心病心绞痛患者116例,其中SAP 54例,UAP组62例,UAP组中cTnI阳性者32例,cTnI阴性者30例,正常对照组35例,测定每位患者的血浆NT-proBNP、cTnI水平,比较不同组别NT-proBNP浓度及分析UAP患者NT-proBNP与cTnI的关系。结果 UAP患者血浆NT-proBNP浓度[146.55(53.65,772.55)pg/ml]高于SAP组[47.50(19.23,87.35)pg/ml]和对照组[33.38(14.07,66.60)pg/ml],差异有统计学意义(P<0.01),SAP组血浆NT-proBNP浓度与对照组比较,差异无统计学意义(P>0.05);UAP患者中cTnI阳性组血浆NT-proBNP浓度[646.86(127.85,1 181.63)pg/ml]高于cTnI阴性组[91.50(26.54,145.83)pg/ml],差异有统计学意义(P<0.01),UAP患者血浆NT-proBNP浓度与cTnI浓度呈正相关(r=0.57,P<0.05)。结论 UAP患者血浆NT-proBNP浓度增高,并与cTnI浓度呈正相关;心肌缺血是NT-proBNP释放的重要刺激因素之一,NT-proBNP与心肌缺血的严重程度有关;测定NT-proBNP有利于发现心功能正常但处于高风险的患者,使患者能得到早期干预,降低心血管事件发生的风险。Objective To investigate the clinical significances of plasma level of N-terminal ProB-type natriureticpeptide（NT-proBNP） between unstable angina pectoris（UAP） and stable angina pectoris（SAP） and correlation betweenplasma cardiac troponin I（cTnI） and NT-proBNP in patients with UAP. Methods 116 patients with angina pectoriswere enrolled in this study, including 54 SAP, 62 UAP. 62 UAP patients were divided into cTnI（＋） group（n= 32） and30 cTnI（-） group（n= 30）, and 30 healthy persons were selected as control. The plasma level of NT-proBNP and cTnI ofall cases were measured and compared in the three groups and the correlation between cTnI and NT-proBNP in UAP pa-tients with cTnI（＋） were analyzed. Results Plasma levels of NT-proBNP were 146. 55（53. 65,772. 55） pg/ ml, 47. 50（19. 23, 87. 35）pg/ ml, 33. 38（14. 07, 66. 60）pg/ ml in the patients with UAP, SAP and control group respectively, thelevel of NT-proBNP in UAP group was significantly higher than that in SAP or control group（P〈0. 01）; there were no sig-nificant difference in NT-proBNP level between SAP and control group（P〉 0. 05）. Plasma levels of NT-proBNP were646. 86（127. 85, 1181. 63） pg/ ml, 91. 50（26. 54, 45. 83）pg/ ml in cTnI（＋） and cTnI（-） group respectively, the plas-ma level of NT-proBNP in the UAP group whose cTnI（＋）was significantly higher than those UAP patients whose cTnI（-）（P〈0. 01）,NT-proBNP level were positively correlated with cTnI in UAP（r= 0. 57,P〈0. 05）. Conclusions The plas-ma level of NT-ProBNP in UAP is increased and it positively correlated with cTnI. All of the patients with coronary heartdisease（CHD） should measure the plasma NT-proBNP to find out the patients at the high risk while whose heart function isnormal, and further to receive the early intervention, and reduce the incidence of cardiovascular risk.

关 键 词：N-末端脑钠肽前体 肌钙蛋白-I 不稳定型心绞痛 稳定型心绞痛 

分 类 号：R542.2[医药卫生—心血管疾病]