血脂及血浆cTnT、BNP与青年急性冠脉综合征的关系  

Relationship among blood lipid,plasma cTnT,BNP levels and acute coronary syndrome in youth

作　　者：李金萍[1] 高淑梅[1] 张志敏[1] 康大伟[2] LI Jing-ping;GAO Shu-mei;ZHANG Zhi-min;KANG Da-wei(ECG Room,Affiliated Hospital of Chengde Medical Col-lege,Chengde,Hebei,067000,China)

机构地区：[1]承德医学院附属医院心电室,河北承德067000 [2]承德医学院附属医院急诊科,河北承德067000

出　　处：《心血管康复医学杂志》2018年第4期398-403,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：承德市科技支撑计划项目(20151025)~~

摘　　要：目的:探究血脂及血浆心肌肌钙蛋白T(cTnT)、脑钠肽(BNP)与青年急性冠脉综合征(ACS)的关系。方法:选择我院收治的年龄≤44岁青年ACS患者264例[急性心肌梗死(AMI)137例、不稳定型心绞痛(UAP)127例],根据病变程度分为单支病变组(78例)、双支病变组(96例)和多支病变组(90例),另选择80例健康者作为健康对照组。对所有受检者血TG、TC、LDL-C、HDL-C、载脂蛋白A-Ⅰ(ApoA-Ⅰ)、ApoB及血浆cTnT、BNP水平进行测定。结果:与健康对照组比较,AMI组和UAP组血浆TG、TC、ApoB、ApoB/ApoA-Ⅰ和cTnT、BNP水平明显升高(P<0.05或<0.01),HDL-C水平显著降低(P均=0.001)。且与UAP组比较,AMI组血浆cTnT、BNP水平升高更显著(P均=0.001)。与单支病变组比较,双支病变组和三支病变组血浆ApoB、ApoB/ApoA-Ⅰ和cTnT、BNP水平显著升高,HDL-C水平显著降低(P均<0.01)。多因素Logistic回归分析显示,血浆cTnT、BNP以及ApoB/ApoA-Ⅰ为青年ACS的独立危险因素(OR=1.089～5.634,P<0.05或<0.01),HDL-C为青年ACS的独立保护因素(OR=0.290,P=0.009)。结论:血脂及血浆心肌肌钙蛋白T、脑钠肽与青年ACS具有密切关系,可作为预测及评价青年ACS的临床指标。Objective： To explore the relationship among levels of blood lipids, plasma cardiac troponin T （cTnT）, brain natriuretic peptide （BNP） and acute coronary syndrome （ACS） in youth. Methods： A total of 264 young ACS patients （≤44 years） treated in our hospital were selected, including 137 cases with acute myocardial infarction （AMI） and 127 cases with unstable angina pectoris （UAP）. They were divided into single vessel coronary disease group （n= 78, single vessel group）, double vessel coronary disease group （n = 96, double vessel group） and multi- vessel coronary disease group （n = 90, multi-vessel group）, another 80 healthy subjects were selected as healthy con- trol group. Levels of TG, TC, LDL-C, HDL-C, apolipoprotein A-t （ApoA-I）, ApoB and plasma eTnT and BNP were measured and compared among all groups. Results： Compared with healthy control group, there were signifi- cant rise in plasma levels of TG, TC, ApoB, ApoB/ApoA-I, cTnT and BNP （P〈0.05 or 〈0.01）, and significant reduction in HDL-C level （P =0. 001 both） in UAP group and AMI group. Compared with UAP group, there were significant rise in plasma levels of cTnT and BNP in AMI group, P = 0. 001 both. Compared with single vessel group, there were significant rise in plasma levels of ApoB, ApoB/ApoA- I , cTnT and BNP, and significant reduc- tion in HDL-C level in double vessel group and multi-vessel group, PG0.01 all. Multi-factor Logistic regression a- nalysis indicated that plasma cTnT, BNP and ApoB/ApoA-I were independent risk factors of young ACS （OR = 1. 089-5. 634, P〈0.05 or 〈0.01）, and HDL-C was the independent protective factor （OR = 0. 290, P = 0. 009）. Conclusion ： Blood lipids, plasma cTnT and BNP are closely associated with ACS in youth, which can be used as clini- cal indexes predicting and assessing ACS in youth.

关 键 词：急性冠状动脉综合征 肌钙蛋白T 利钠肽 脑 

分 类 号：R541.409[医药卫生—心血管疾病]