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1、腦鈉肽及冠脈造影病變關系探究作者:鄧新桃,石桂良,鄭金國,趙建祥,洪淵,馬根山【摘要】目的:觀察血清腦鈉肽(BNP)濃度的變化與冠脈病變之間的關系。方法:臨床擬診冠心病患者374例,按冠脈造影結果分為陽性組(235例)、陰性組(139例),并根據(jù)冠狀動脈病變的范圍分為單支血管病變組(64例)、雙支血管病變組(79例)和三支血管病變組(92例),均于入院時測定血清中BNP、C反應蛋白(CRP)水平,進行統(tǒng)計分析。結果:陽性組BNP濃度為(115.91±53.64)pg/ml,陰性組(37.70±33.61)pg/ml,兩組間差異有統(tǒng)計學
2、意義,P<;0.01;單支病變組濃度為(96.49±12.09)pg/ml>雙支病變組濃度為(113.49±11.94)pg/ml.三支病變組濃度為(121.80±9.77)pg/ml,單因素方差分析示組間差異有統(tǒng)計學意義,P<;0.05;多因素Logistic分析結果示BNP水平與冠脈造影(CAG)診斷冠心病(CHD)結果明顯相關。結論:血清BNP水平是冠心病的獨立危險因素,其水平的增高對冠心病患者病變累及的程度可能有一定臨床參考價值,且BNP是較CRP更敏感的指標?!娟P鍵詞】腦鈉肽;C反應蛋白;冠心??;冠狀動脈造影[Abs
3、tract]Objective:Toinvestigatetherelationshipbetweentheserumbrainnatriureticpeptide(BNP)concentrationvariancesandcoronaryangiographydisease?Methods:AccordingtotheresuItsofcoronaryangiography,374casesweredividedintoCHDgroup(235cases)andtheNonCHDgroup(139cases).Accordingto
4、thescopeofcoronaryarterydisease,theCHDgroupweredividedintosinglevesseldiseasegroup(64cases),doublevesseldiseasegroup(79cases)andthreevesseldiseasegroup(92cases).AllcaseswererespectivelymeasuredserumBNPandCRPlevelsonadmission,thenanalyzed.ResuIts:LevelsofserumBNPoftheCHD
5、group(115.91±53.64)pg/mlweresignificantlyelevatedcomparedwithNonCHDgroup(37.70±33.61)pg/ml,P<;0.01.LevelsofserumBNPofthesinglevesseldiseasegroupis(96?49±12.09)pg/ml,doublevesseldiseasegroup(113.49±11.94)pg/ml,threelesions(121.80+9.77)pg/ml?OnewayANOVAshowedsignificant
6、differencesamonggroups,P&It;0.05.MultinomiallogisticanalysisshowedBNPlevelssignificantlycorrelatedCHD.Conelusion:SerumBNPlevelwasanindependentriskfactorforcoronaryheartdisease?TheirlevelsincreasedinCHDpatientsmayhavesomedegreeofclinicalreferencevalueforlesionsinvolvingt
7、heextentofcoronaryartery,andBNPwasamoresensitiveindicatorthanCRP?_Keywords]brainnatriureticpeptide;Creactiveprotein;coronaryheartdisease;coronaryangiography冠心病的各種危險因素不斷地被發(fā)現(xiàn)和證明,且均已成為預防和治療冠心病的關鍵靶點。腦鈉肽(brainnatriureticpeptide,BNP)與心血管疾病的關系以及作用機制正成為近年研究的熱點。C反應蛋白(Creactivepr
8、oteinCRP)水平的升高和造影所示冠脈病變數(shù)相關,病變數(shù)越多,血CRP水平越高。本研究測定冠心病患者血漿BNP、CRP水平,旨在探討它們對冠心病短期預后的預測價值及兩者之間的相關性,為評價冠心病的病情提供新的理論依據(jù)