论文部分内容阅读
目的探讨不稳定型心绞痛患者与急性心力衰竭患者的BNP及相关指标的变化。方法选择本院心内科2008年1月—2011年12月住院患者180例,根据患者BNP水平不同分为不稳定型心绞痛组(n=90)和急性心力衰竭组(n=90),测定以上两组患者BNP、肌钙蛋白水平及HDL-C、LDL-C、前白蛋白、纤维结合蛋白、尿酸水平,彩色多普勒超声测定左室射血分数(left ventricular ejection fraction,LVEF),计量资料以±s表示,采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果不稳定型心绞痛组患者BNP为(32.68±18.40)pg/ml,LVEF为(67.03±3.59)%,急性心力衰竭组患者BNP为(1 778.68±663.72)pg/ml,LVEF为(38.68±6.52)%,两组差异均有统计学意义(均P<0.05)。急性心力衰竭组较不稳定型心绞痛组患者前白蛋白、HDL-C、LDL-C水平明显降低,尿酸水平、肌钙蛋白升高[(215.60±69.34)mg/L、(1.03±0.48)、(2.43±0.21)mmol/L、(432.54±85.67)μmol/L、(0.160 3±0.386 0)ng/ml、(281.55±49.02)mg/L、(1.36±0.76)、(2.79±0.45)mmol/L、(328.95±60.32)μmol/L、(0.003 2±0.005 4)ng/ml],两组差异均有统计学意义(均P<0.05)。结论不稳定型心绞痛与心力衰竭患者机体脂代谢、蛋白代谢能力逐步下降,但心力衰竭患者下降得更为明显。心力衰竭患者BNP水平明显升高,心肌细胞损伤更为严重。
Objective To investigate the changes of BNP and related indexes in patients with unstable angina and acute heart failure. Methods One hundred and eighty inpatients from January 2008 to December 2011 in our department of cardiology were divided into unstable angina pectoris group (n = 90) and acute heart failure group (n = 90) according to the level of BNP. Plasma BNP and troponin levels, HDL-C, LDL-C, prealbumin, fibronectin and uric acid were measured in both groups. Left ventricular ejection fraction (LVEF) was measured by color Doppler sonography. Data to ± s said, using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results BNP was (32.68 ± 18.40) pg / ml, LVEF was 67.03 ± 3.59% in patients with unstable angina pectoris, (1778.68 ± 663.72) pg / ml in patients with acute heart failure, and LVEF was (38.68 ± 6.52) )%, The differences between the two groups were statistically significant (P <0.05). HDL-C, LDL-C levels in patients with acute heart failure were significantly lower than those in patients with unstable angina, uric acid levels and troponin levels were elevated (215.60 ± 69.34 mg / L, 1.03 ± 0.48, (2.43 ± 0.21) mmol / L, (432.54 ± 85.67) μmol / L, (0.160 3 ± 0.386 0) ng / ml, (281.55 ± 49.02) mg / L, (1.36 ± 0.76) and (2.79 ± 0.45) mmol / (32.8.95 ± 60.32) μmol / L, (0.003 2 ± 0.005 4) ng / ml]. There was significant difference between the two groups (all P <0.05). Conclusions Patients with unstable angina pectoris and heart failure have a gradual decline in lipid metabolism and protein metabolism, but patients with heart failure decline more obviously. BNP levels in patients with heart failure increased significantly, myocardial cell injury is more serious.