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目的观察外周血浆脑钠肽(BNP)浓度与冠脉病变之间的关系。方法选择临床拟诊冠心病患者374例,按冠脉造影结果分为阳性组(235例)、阴性组(139例),并按根据冠状动脉病变的范围分为单支血管病变组(64例)、双支血管病变组(79例)和三支血管病变组(92例),均于入院时测定血清中BNP、CRP水平,并进行统计学分析。结果374例患者中阳性组BNP浓度为(116±54)pg/ml,阴性组为(38±34)pg/ml,两组间差异有统计学意义(P<0.01);单支病变组浓度为浓度为(96±12)pg/ml,双支病变组浓度为(113±12)pg/ml,三支病变组浓度为(122±10)pg/ml,单因素方差分析示组间差异有统计学意义(P<0.05);多因素Logistic分析结果示BNP水平与CAG诊断CHD结果明显相关。结论血清BNP水平是冠心病的独立危险因素,其水平的增高对冠心病患者血管病变累及的程度可能有一定临床参考价值,且BNP是较CRP更敏感的指标。
Objective To observe the relationship between peripheral plasma brain natriuretic peptide (BNP) levels and coronary artery lesions. Methods A total of 374 patients with clinically suspected CHD were enrolled in this study. They were divided into positive group (235 cases) and negative group (139 cases) by coronary angiography. According to the extent of coronary artery disease, they were divided into single vessel disease group (64 cases ), Double vessel disease group (n = 79) and triple vessel disease group (n = 92). The levels of BNP and CRP in serum were measured at admission and were analyzed statistically. Results The BNP concentration in the positive group was (116 ± 54) pg / ml in 374 patients and that in the negative group was (38 ± 34) pg / ml, with significant difference between the two groups (P <0.01) (113 ± 12) pg / ml for the double-vessel disease group and (122 ± 10) pg / ml for the three-vessel disease group. The difference between groups was shown by one-way ANOVA (P <0.05). The multivariate Logistic analysis showed that the level of BNP was significantly correlated with the diagnosis of CHD by CAG. Conclusions Serum BNP level is an independent risk factor for coronary heart disease. The increased level of BNP may have clinical significance for the degree of vascular lesions in patients with coronary heart disease, and BNP is more sensitive than CRP.