血浆氨基末端B型脑钠肽前体与老年急性冠状动脉综合征患者危险因素的相关性  

Correlation analysis between NT-proBNP and risk factors of acute coronary syndrome to elder patients

作　　者：韦艳红[1] 刘艳[1] 康晓新[1] 赵宇[1] 尹璐 

机构地区：[1]161000,齐齐哈尔医学院附属第三医院老年科

出　　处：《中国综合临床》2015年第8期-,共4页Clinical Medicine of China

摘　　要：目的 探讨血浆氨基末端B型脑钠肽前体(NT-proBNP)水平与老年急性冠状动脉综合征(ACS)患者危险因素的相关性.方法 将128例ACS患者根据病情分为不稳定型心绞痛(UAP)组52例,ST段抬高型心肌梗死(STEMI)组35例,非ST段抬高型心肌梗死(NSTEMI)组41例,并选取健康老年人45名作为健康对照组.记录受试者血压、体质量指数(BMI)、每日吸烟数等一般资料.抽取静脉血进行血浆NT-proBNP、心肌肌钙蛋白I(cTnI)、同型半胱氨酸(Hcy)、血脂、C反应蛋白(CRP)等实验室检查.通过超声心动图测量左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)和左心室射血分数(LVEF),并比较NT-proBNP与其他指标的相关性.结果 UAP组、STEMI组、NSTEMI组患者NT-proBNP水平均显著高于健康对照组[(794.18± 182.64)、(872.43± 245.67)、(557.25±163.81) ng/L与(125.84±59.27) ng/L,P均＜0.05];ACS患者血浆NT-proBNP与收缩压、舒张压、Hcy和CRP水平呈正相关(r值分别为0.182、0.176、0.281、0.191,P值分别为0.040、0.043、0.001、0.031);与LVEF水平呈负相关(r=-0.247,P=0.005).结论 血浆NT-proBNP是监测ACS病情的敏感指标,其与Hcy、CRP、cTnI联合检测对诊断和治疗ACS具有指导意义.Objective To study the correlation between amino terminal B-type natriuretic peptide precursor(NT-proBNP) and risk factors of acute coronary syndrome (ACS) with elder patients.Methods One hundred and twenty-eight ACS patients were divided into unstable angina pectoris (UAP) group with 52 samples,ST elevation myocardial infarction (STEMI) group with 35 samples and non-ST elevation myocardial infarction (NSTEMI) group with 41 samples.Meanwhile 45 healthy elder people were adopted as control group.Firstly,the subjects of blood pressure,body mass index (BMI) and smoking numbers were measured.Secondly,venous blood was collected to assay NT-proBNP,cardiac troponin Ⅰ (cTn Ⅰ),homocysteine (Hcy),blood-lipoids and C-reactive protein(CRP).Lastly,ultrasonic cardiogram was used to test left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter (LVESD) and left ventricular ejection fraction (LVEF).In addition,correlation analysis was researched between NT-proBNP and other factors.Results NT-proBNP levels of UAP,STEMI and NSTEMI groups were significantly higher than the control group ((794.18±182.64) ng/L,(872.43±245.67) ng/L,(557.25±163.81) ng/L) and (125.84±59.27) ng/L,P ＜ 0.05).NT-proBNP was positive correlation with systolic blood pressure,diastolic blood pressure,Hcy and CRP (r=0.182,0.176,0.281,0.191;P=0.040,0.043,0.001,0.031),however negative with LVEF(r=-0.247,P =0.005).Conclusion NT-proBNP level is sensitive to monitor ACS variety,and it is significant to test NT-proBNP combining Hcy,CRP,and cTn Ⅰ for diagnosing and treating ACS.

关 键 词：氨基末端B型脑钠肽前体 急性冠状动脉综合征 同型半胱氨酸 C反应蛋白 

分 类 号：R5[医药卫生—内科学]