目的观察冠心病患者血浆氨基末端脑钠肽前体(NT-proBNP)水平变化,探讨血浆NT-proBNP水平评价冠心病严重程度价值。方法选择住院治疗,并行冠状动脉造影的患者205例,LVEF 75%共182例,分为急性心肌梗死(AMI)组(41例),不稳定性心绞痛(UAP)组(85例),稳定性心绞痛(SAP)组(40例)和正常组(16例);又根据冠状动脉造影分为单支病变组(52例)、双支病变组(49例)、多支病变组(64例)和零支病变组(40例)。采用Gensini积分法评价冠状动脉病变的狭窄严重程度,测定血浆NT-proBNP水平以及LVEF。结果AMI组和UAP组血浆NT-proBNP水平明显高于SAP组和正常组(P<0.05)。单支病变组、双支病变组和多支病变组血浆NT-proBNP水平明显高于零支病变组(P<0.05)。血浆NT-proBNP水平与LVEF呈负相关,与Gensini积分呈正相关。结论AMI和UAP患者血浆NT-proBNP水平明显升高,可能是冠心病危险分层的有效指标。 Objective To observe the changes of plasma NT-proBNP level in patients with coronary heart disease (CHD) and to evaluate the value of plasma NT-proBNP in evaluating the severity of coronary heart disease. Methods Totally 205 patients with in-hospital and concurrent coronary angiography were enrolled. A total of 182 LVEF patients were divided into acute myocardial infarction (AMI) group (41 cases) and unstable angina pectoris group (UAP) group (85 cases) According to coronary angiography, the patients were divided into single vessel disease group (52 cases), double vessel disease group (49 cases), multivessel disease group (64 cases), angina pectoris group (40 cases) and normal group And zero-defect group (40 cases). Gensini integral method was used to assess the severity of coronary artery stenosis, plasma NT-proBNP levels and LVEF were measured. Results The plasma levels of NT-proBNP in AMI group and UAP group were significantly higher than those in SAP group and normal group (P <0.05). The levels of plasma NT-proBNP in single-vessel disease group, double-vessel disease group and multi-vessel disease group were significantly higher than those in the zero-vessel disease group (P <0.05). Plasma NT-proBNP levels were negatively correlated with LVEF and positively correlated with Gensini scores. Conclusion The plasma levels of NT-proBNP in patients with AMI and UAP are significantly increased, which may be an effective indicator of risk stratification of coronary heart disease.