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目的探讨在心功能正常情况下不稳定型心绞痛(unstable angina pectoris,UAP)与稳定型心绞痛(stable angina pectoris,SAP)患者血浆N-末端脑钠肽前体(NT-proBNP)浓度的差异及UAP患者血浆NT-proBNP浓度与肌钙蛋白I(cTnI)的相关性及其临床意义。方法选择住院冠心病心绞痛患者116例,其中SAP 54例,UAP组62例,UAP组中cTnI阳性者32例,cTnI阴性者30例,正常对照组35例,测定每位患者的血浆NT-proBNP、cTnI水平,比较不同组别NT-proBNP浓度及分析UAP患者NT-proBNP与cTnI的关系。结果 UAP患者血浆NT-proBNP浓度[146.55(53.65,772.55)pg/ml]高于SAP组[47.50(19.23,87.35)pg/ml]和对照组[33.38(14.07,66.60)pg/ml],差异有统计学意义(P<0.01),SAP组血浆NT-proBNP浓度与对照组比较,差异无统计学意义(P>0.05);UAP患者中cTnI阳性组血浆NT-proBNP浓度[646.86(127.85,1 181.63)pg/ml]高于cTnI阴性组[91.50(26.54,145.83)pg/ml],差异有统计学意义(P<0.01),UAP患者血浆NT-proBNP浓度与cTnI浓度呈正相关(r=0.57,P<0.05)。结论 UAP患者血浆NT-proBNP浓度增高,并与cTnI浓度呈正相关;心肌缺血是NT-proBNP释放的重要刺激因素之一,NT-proBNP与心肌缺血的严重程度有关;测定NT-proBNP有利于发现心功能正常但处于高风险的患者,使患者能得到早期干预,降低心血管事件发生的风险。
Objective To investigate the difference of plasma N-terminal pro brain natriuretic peptide (NT-proBNP) concentrations in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) Correlation between Plasma NT-proBNP Concentration and Troponin I (cTnI) and Its Clinical Significance. Methods A total of 116 patients with coronary heart disease and angina pectoris were enrolled in this study. Among them, 54 were SAP, 62 UAP patients, 32 cTnI positive patients, 30 cTnI negative patients and 35 normal controls. The plasma levels of NT-proBNP , CTnI levels, NT-proBNP concentrations in different groups were compared and the relationship between NT-proBNP and cTnI in UAP patients was analyzed. Results The plasma concentrations of NT-proBNP in patients with UAP [146.55 (53.65,772.55) pg / ml] were significantly higher than those in SAP patients [47.50 (19.23,87.35) pg / ml] and those in the control group [33.38 (14.07,66.60 pg / ml] (P <0.01). The plasma concentration of NT-proBNP in SAP group was not significantly different from that in control group (P> 0.05). The plasma concentration of NT-proBNP in cTnI-positive group was 646.86 (127.85, (P <0.01). There was a positive correlation between NT-proBNP concentration and cTnI concentration in patients with UAP (r = 0.57 , P <0.05). Conclusion The plasma concentration of NT-proBNP is increased in patients with UAP and positively correlated with the concentration of cTnI. Myocardial ischemia is one of the important stimulating factors of NT-proBNP release. NT-proBNP is related to the severity of myocardial ischemia. Discovering patients with normal cardiac function but at high risk enables early intervention and reduces the risk of cardiovascular events.