血浆氨基末端脑钠肽前体水平与急性ST段抬高型心肌梗死患者冠状动脉病变程度的关系研究  

Correlation between Serum NT-pro BNP Level and Severity of Coronary Artery Lesions in Patients with STEMI

作　　者：陈旭虞[1] 夏豪[2] 

机构地区：[1]广西钦州市第二人民医院,535000 [2]武汉大学人民医院

出　　处：《实用心脑肺血管病杂志》2015年第5期5-8,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家自然科学基金资助项目(81270184)

摘　　要：目的探讨血浆氨基末端脑钠肽前体(NT-pro BNP)水平与急性ST段抬高型心肌梗死(STEMI)患者冠状动脉病变程度的关系。方法选取广西钦州市第二人民医院2012年3月—2015年3月收治的STEMI患者252例,根据血浆NT-pro BNP水平分为NT-pro BNP正常组(NT-pro BNP<800 ng/L)126例和NT-pro BNP升高组(NT-pro BNP>800 ng/L)126例。所用患者入院后进行全面询问病史、体格检查并记录年龄、性别、冠心病家族史、吸烟史及高血压、高脂血症、糖尿病发病情况,入院后24 h内测定血浆NT-pro BNP、肌酸激酶同工酶(CK-MB)、肌红蛋白(MYO)、超敏肌钙蛋白I(ultra-Tn I)水平,入院第2天清晨采集空腹静脉血检测血脂,采用Judkins法进行冠状动脉造影检查。比较两组患者一般资料、冠状动脉造影结果,并分析血浆NT-pro BNP水平与Gensini积分的相关性。结果 NT-pro BNP升高组患者高血压发生率、ultra-Tn I水平高于NT-pro BNP正常组(P<0.05)。两组患者性别、年龄、高脂血症发生率、糖尿病发生率、冠心病家族史和吸烟史阳性率及CK-MB、MYO、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异均无统计学意义(P>0.05)。NT-pro BNP升高组冠状动脉三支病变发生率高于NT-pro BNP正常组,单支病变、双支/左主干病变发生率低于NT-pro BNP正常组(P<0.05)。NT-pro BNP升高组患者冠状动脉病变支数多于NT-pro BNP正常组,Gensini积分高于NT-pro BNP正常组(P<0.05)。直线相关分析结果显示,血浆NT-pro BNP水平与Gensini积分呈正相关(r=0.813,P=0.000)。结论血浆NT-pro BNP水平与STEMI患者冠状动脉病变程度有关,可通过检测血浆NT-pro BNP水平来判断冠状动脉病变程度。Objective To explore the correlation between serum NT-pro BNP level and severity of coronary artery lesions in patients with STEMI.Methods A total of 252 patients with STEMI were selected in the Second People＇ s Hospital of Qinzhou from March 2012 to March 2015,and they were divided into groups A（NT-pro BNP〈 800 ng / L） and B（NT-pro BNP≥ 800 ng/L） according to serum NT-pro BNP level,each of 126 cases.Age,gender,family history of coronary heart disease,smoking history,and incidence of hypertension,hyperlipidaemia and diabetes were recorded after admission;serum levels of NT-pro BNP,CK-MB,MYO,ultra-Tn I were detected within 24 hours after admission;fasting venous blood was collected to detect the blood lipid on the second day morning after admission;Judkins method was used to carry out coronary arteriography;linear correlation analysis was used to analyze the correlation between serum NT-pro BNP level and Gensini score.Results The incidence of hypertension,serum ultra-Tn I level of B group was statistically significantly higher than that of A group,respectively（P〈0.05）;while no statistically significant differences of gender,age,CK-MB,MYO,TC,TG,HDL-C,LDL-C,incidence of hyperlipidaemia or diabetes,positive rate of family history of coronary heart disease or smoking history was found between the two groups（P〉0.05）.The incidence of three-vessel lesions of B group was statistically significantly higher than that of B group,while single-vessel and double-vessel lesions（including left main coronary artery lesions） of B group were statistically significantly lower than those of A group（P〈0.05）.The number of coronary artery lesions of B group was statistically significantly more than that of A group,and Gensini score of B group was statistically significantly higher than that of A group（P〈0.05）.Linear correlation analysis showed that,serum NT-pro BNP level was positively correlated with Gensini score（r = 0.813,P = 0.000）.Conclusion Serum NT-pro BNP level is correlated with the

关 键 词：利钠肽 脑 冠心病 冠状动脉狭窄 

分 类 号：R543.3[医药卫生—心血管疾病]