N端脑钠肽前体、高敏C反应蛋白、左心室射血分数与不同类型冠心病及冠脉病变程度相关性分析
投稿时间:2015-10-08  修订日期:2015-10-19  点此下载全文
引用本文:王晓艳,应光荣,骆金伟,龚鸿霞,龚俊平,骆高江.N端脑钠肽前体、高敏C反应蛋白、左心室射血分数与不同类型冠心病及冠脉病变程度相关性分析[J].医学研究杂志,2016,45(4):126-129
DOI: 10.11969/j.issn.1673-548X.2016.04.033
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作者单位E-mail
王晓艳 322000 义乌市中心医院  
应光荣 322000 义乌市中心医院  
骆金伟 322000 义乌市中心医院  
龚鸿霞 322000 义乌市中心医院  
龚俊平 322000 义乌市中心医院  
骆高江 322000 义乌市中心医院 luogaojiang@sohu.com 
中文摘要:目的 探讨不同类型冠心病患者血清N端脑钠肽前体(NT-proBNP)、高敏C反应蛋白(hsCRP)和左心室射血分数(LVEF)的变化及其与冠脉病变程度的相关性。方法 根据冠脉造影结果,将146例住院患者分为对照组51例和冠心病组95例。冠心病组根据临床表现分为稳定型心绞痛组(SAP)28例、不稳定型心绞痛组(UAP)44例和急性心肌梗死组(AMI)23例,根据Gensini积分法对冠心病患者冠状动脉狭窄程度进行定量评估,分为0~20分,20~40分和>40分3组。采用化学发光微粒免疫分析(CMIA)法测定血清NT-proBNP浓度,采用免疫透析比浊法测定血清hs-CRP。结果 UAP组和AMI组血清NT-proBNP、hsCRP浓度明显高于对照组和SAP组(P<0.05);AMI组LVEF值明显低于对照组、SAP组和UAP组(P<0.05);随着冠脉病变程度的增加,血清NT-proBNP、hsCRP水平显著增高(P<0.05);血清NT-proBNP浓度与LVEF呈负相关(r=-0.413,P=0.00),与hsCRP呈正相关(r=0.194,P=0.019),与Gensini积分呈正相关(r=0.242,P=0.018),与冠脉病变支数无相关(r=0.010,P=0.922)。结论 血清N端脑钠肽前体(NT-proBNP)、高敏C反应蛋白(hsCRP)和左心室射血分数(LVEF)的变化与不同类型冠心病相关,同时也与冠脉病变程度相关,可以用于反映心肌受损程度,对冠心病患者进行危险分层和分析预后有一定的临床意义。
中文关键词:冠状动脉粥样硬化性心脏病  N端脑钠肽前体  高敏C反应蛋白  左心室射血分数
 
Correlation Analysis Between N-terminal Pro-brain Natriuretic Peptide, High-sensitivity C-reactive Protein, Left Ventricular Ejection Fraction and Different Types of Coronary Heart Disease and Degree of Coronary Artery Disease
Abstract:Objective To investigate change in N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), left ventricular ejection fraction (LVEF) of different types of coronary heart disease (CHD) and its correlation with degree of coronary artery disease. Methods The 146 inpatients were divided into control group (51 cases) and CHD group (95 cases) according to the results of coronary angiography (CAG). CHD group were divided into stable angina pectoris (SAP) 28 cases, unstable angina pectoris (UAP) 44 cases, and acute myocardial infarction (AMI) 23 cases based on clinical manifestations. Degree of coronary artery stenosis in patients with CHD was quantitatively assessed by Gensini score, and divided into 3 groups (0-20 points, 20-40 points and >40 points). Serum concentration of NT-proBNP was measured by using chemiluminescent microparticle immunoassay (CMIA) method, and serum concentration of hs-CRP was measured by Immunohistochemical dialysis method. Results Serum concentration of NT-proBNP, hsCRP in UAP and AMI group was significantly higher than in SAP group (P<0.05). LVEF value in AMI group was significantly lower than in control group, SAP and UAP group (P<0.05). With the increase in the degree of coronary artery disease, serum NT-proBNP, hsCRP levels were significantly raising (P<0.05). Serum concentration of NT-proBNP was negatively correlated with LVEF (r=-0.413, P=0.000), positively correlated with hsCRP (r=0.194, P=0.019), positively correlated with Gensini score (r=0.242, P=0.018), no correlation with the number of coronary lesion branches (r=0.010, P=0.922). Conclusion Changes in NT-proBNP, hsCRP, LVEF are related with different types of CHD and degree of coronary artery disease. They can be used to reflect the degree of myocardial damage, and have some clinical significance for risk stratification and prognosis analysis of CHD.
keywords:Coronary heart disease  N-terminal pro-brain natriuretic peptide  High-sensitivity C-reactive protein  Left ventricular ejection fraction
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