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目的探讨急性冠状动脉综合征患者血清N末端B型钠尿肽前体(NT-proBNP)和肌钙蛋白I(cTnI)含量与冠状动脉病变程度的关系。方法选择急性冠状动脉综合征患者98例,分为急性ST段抬高心肌梗死(STEMI)组46例,急性非ST段抬高心肌梗死(NSTEMI)组16例,不稳定性心绞痛(UAP)组36例,均于入院时或发病24 h内测定患者血清NT-proBNP、cTnI含量,冠状动脉造影了解冠状动脉病变情况,并行心脏彩色多普勒超声检测,以评估患者的心功能。结果与UAP组比较,STEMI组和NSTEMI组NT-proBNP明显升高;与NSTEMI组比较,STEMI组cTnI明显升高(P<0.05)。NT-proBNP与冠状动脉病变积分呈正相关(r=0.156,P<0.05),与LVEF呈负相关(r=-0.196,P<0.01);cTnI与冠状动脉病变积分呈正相关(r=0.247,P<0.01)。结论急性冠状动脉综合征患者NT-proBNP与cTnI无关,但两者均可反映冠状动脉病变的严重程度。NT-proBNP的高低能反映患者的心功能状态,cTnI则与心功能无关。
Objective To investigate the relationship between serum NT-proBNP and troponin I (cTnI) levels and the degree of coronary artery lesions in patients with acute coronary syndrome. Methods A total of 98 patients with acute coronary syndrome (ACS) were enrolled in this study. They were divided into acute ST-elevation myocardial infarction (STEMI) group (46 cases), acute non-ST-segment elevation myocardial infarction (NSTEMI) group (16 cases), unstable angina pectoris group Thirty-six patients were enrolled in the study. Serum NT-proBNP and cTnI levels were measured at admission or within 24 hours after onset. Coronary artery angiography was performed to assess coronary artery lesions. Cardiac color Doppler ultrasound was performed to evaluate cardiac function. Results Compared with UAP group, NT-proBNP in STEMI group and NSTEMI group was significantly increased. Compared with NSTEMI group, cTnI in STEMI group was significantly increased (P <0.05). There was a positive correlation between NT-proBNP and coronary artery disease score (r = 0.156, P <0.05) and negative correlation with LVEF (r = -0.196, P <0.01) <0.01). Conclusion NT-proBNP is not related to cTnI in patients with acute coronary syndrome, but both can reflect the severity of coronary artery disease. NT-proBNP level reflects the patient’s cardiac function status, cTnI has nothing to do with cardiac function.