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目的探讨老年急性冠脉综合征(ACS)患者血清中氨基末端B型脑钠肽前体(NT-proBNP)与血清尿酸(UA)的变化的关系。方法选择临床及冠状动脉造影明确诊断老年急性冠脉综合征患者85例[其中急性心肌梗死(AMI)38例、不稳定型心绞痛(UAP)47例]。另选老年冠状动脉造影正常者40例为正常对照组。分别检测血清NT-proB-NP、UA的浓度,比较AMI组和UAP组患者的血清NT-proBNP和超敏C-反应蛋白(hs-CRP)与UA水平。结果老年急性冠脉综合征(ACS)患者血清NT-proBNP和hs-CRP与血清尿酸(UA)明显高于对照组。各组血清NT-proBNP和hs-CRP与血清尿酸(UA)水平两两比较,差异有统计学意义(P<0.01)。冠脉狭窄各组血清NT-proBNP、UA、hs-CRP的水平较正常冠脉组明显增高(P<0.01),且随冠状动脉狭窄程度加重。各组间血清NT-proBNP、UA比较,随冠脉病变支数增加,血清NT-proBNP、UA、hs-CRP的水平增高。结论 ACS患者血清NT-proBNP和hs-CRP水平与血清UA水平升高与老年急性冠脉综合征密切相关,是老年急性冠脉综合征危险因素。
Objective To investigate the relationship between the serum levels of NT-proBNP and serum uric acid (UA) in elderly patients with acute coronary syndrome (ACS). Methods Eighty-five elderly patients with acute coronary syndrome (including 38 with AMI and 47 with unstable angina) were selected for clinical and coronary angiography. Another 40 cases of normal coronary angiography were normal control group. Serum levels of NT-proBNP and UA were measured respectively. Serum levels of NT-proBNP and hs-CRP and UA in patients with AMI and UAP were compared. Results Serum NT-proBNP, hs-CRP and serum uric acid (UA) in elderly patients with acute coronary syndrome were significantly higher than those in the control group. The serum levels of NT-proBNP, hs-CRP and serum uric acid (UA) in each group were compared between two groups, the difference was statistically significant (P <0.01). Serum levels of NT-proBNP, UA and hs-CRP in coronary artery stenosis group were significantly higher than those in normal coronary artery group (P <0.01), and with the severity of coronary artery stenosis. The levels of NT-proBNP, UA and hs-CRP in serum of all groups increased with the increase of coronary artery lesion count. Conclusion Serum levels of NT-proBNP and hs-CRP and serum UA levels in patients with ACS are closely related to elderly acute coronary syndromes and are risk factors for the elderly with acute coronary syndrome.