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目的探讨血浆N端前体脑钠肽(NT-proBNP)水平和稳定型心绞痛合并糖尿病患者冠状动脉病变(狭窄严重性和狭窄冠脉数量)之间的关系。方法稳定型心绞痛住院病人161例[(62.0±7.3)岁,女性42.9%]中,经肘前静脉直接穿刺抽血化验NT-proBNP。同时,所有病人都接受冠状动脉造影检查。根据是否合并糖尿病,随机分2组:稳定型心绞痛合并糖尿病患者(A组,n=83);稳定型心绞痛无糖尿病患者(B组,n=78)。基于血管造影的结果,分别将两组各分3个亚组:1组,没有一支冠脉直径狭窄>50%(无显著狭窄);2组,1支血管狭窄>75%(1支血管病变);3组,2支或3支血管狭窄>75%(多于2支血管病变)。结果稳定型心绞痛并糖尿病患者血NT-proBNP水平(750±80)ng/L明显高于无糖尿病患者(450±75)ng/L(P<0.05);随着冠状动脉狭窄程度的增加,NT-proBNP血浆水平亦显著增加(P<0.05);血浆NT-proBNP水平正相关于点变量分析的Gensini评分(r=0.725,P<0.05)。在多变量分析中,NT-proBNP是稳定型心绞痛并糖尿病冠状动脉疾病的一个独立预测因子。结论独立于血流动力学超负荷,随着稳定型心绞痛并糖尿病冠状动脉狭窄程度的增加,血浆NT-proBNP水平随着增加。在稳定型心绞痛并糖尿病病人中,NT-proBNP是一个有用的检测指标,可用于评估冠脉狭窄的程度。
Objective To investigate the relationship between plasma N-terminal pro brain natriuretic peptide (NT-proBNP) levels and coronary artery disease (stenosis severity and stenosis coronary artery disease) in patients with stable angina pectoris and diabetes mellitus. Methods 161 patients with stable angina pectoris [(62.0 ± 7.3) years old and 42.9% female] were enrolled in this study. NT-proBNP was directly obtained through the antecubital vein. At the same time, all patients underwent coronary angiography. Patients with stable angina pectoris and diabetes (group A, n = 83) and patients without stable angina pectoris (group B, n = 78) were randomized into two groups according to whether they had diabetes mellitus or not. Based on the results of angiography, the two groups were divided into three subgroups: one group, none of which had coronary stenosis> 50% (no significant stenosis); two groups, one with stenosis> 75% (one vessel Lesions); 3, 2, or 3 vessel stenoses> 75% (more than 2 vessel lesions). Results The blood levels of NT-proBNP in patients with stable angina and diabetes (750 ± 80 ng / L) were significantly higher than those in non-diabetic patients (450 ± 75 ng / L, P0.05). With the increase of coronary stenosis, NT (P <0.05). Plasma NT-proBNP levels were positively correlated with the Gensini score (r = 0.725, P <0.05) of the point-variable analysis. In multivariate analysis, NT-proBNP is an independent predictor of stable angina and diabetic coronary artery disease. Conclusions Independent of hemodynamic overload, plasma NT-proBNP levels increase with increasing levels of coronary artery stenosis in patients with stable angina and diabetes. In patients with stable angina and diabetes, NT-proBNP is a useful measure of coronary artery stenosis and can be used to assess the extent of coronary artery stenosis.