中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
1期
35-37
,共3页
盖延红%栾晓东%张瑞军%徐丹
蓋延紅%欒曉東%張瑞軍%徐丹
개연홍%란효동%장서군%서단
急性冠状动脉综合征%脑钠肽%高敏C反应蛋白%脂蛋白(a)
急性冠狀動脈綜閤徵%腦鈉肽%高敏C反應蛋白%脂蛋白(a)
급성관상동맥종합정%뇌납태%고민C반응단백%지단백(a)
Acute coronary syndrome%Natriuretic eptide brain%High sensitive C-reactive protein%Leptein(a)
目的 探讨血清脑钠肽(BNP)与急性冠状动脉综合征之间的相关性及可能的临床意义.方法 研究对象为急性心肌梗死患者36例(AMI组),不稳定型心绞痛患者38例(UAP组),稳定型心绞痛患者30例(SAP组),健康体检者30例(对照组).用酶联免疫吸附分析法测定所有研究对象的血清BNP、hs-CRP和Lp(a)浓度,并行心脏超声检查,测定左心室射血分数(LVEF)、左心室收缩末期容积(LVEDV)及舒张末期容积( LVESV).结果 AMI组的BNP、hs-CRP、Lp(a)水平分别为(391±136) ng/L、( 16±15) mg/L、(367±191 )mg/L.UAP组分别为(267±80) ng/L、(11±7) mg/L、(324±171) mg/L.SAP组分别为(36±21) ng/L、(2±1)mg/L、(191±130) mg/L.对照组分别为(33±14) ng/L、(1.0±0.4)mg/L、(150±116)mg/L.AMI组和UAP组上述指标与对照组及SAP相比,差异有统计学意义(P＜0.05或P＜0.01).AMI组与SAP组上述指标比较,差异有统计学意义(均P ＜0.05).AMI组与UAP组比较,差异无统计学意义(均P＞0.05).AMI组LVEDV、LVESV、LVEF分别为(95±19)、(43±9)ml,(0.51±0.08)；UAP组分别为(93±23)、(42±8)ml,(0.55 ±0.08)；AP组分别为(86±18)、(32±9)ml,(0.64±0.09)；对照组分别为(86±18)、(29±9)ml,(0.66±0.09).AMI组、UAP组与SAP组及对照组比较,差异均有统计学意义(P＜0.01).AMI组与UAP组比较,差异无统计学意义(P＞0.05).SAP组与对照组比较,差异无统计学意义(P＞0.05).多元回归分析表明,在ACS患者中,BNP浓度与hs-CRP和Lp(a)呈正相关,(r=0.53,P＜0.01;r=0.543,P＜0.01).BNP浓度与LVEF明显负相关(r=-0.44,P＜0.01).控制年龄、性别、体表面积后计算两变量间偏相关系数.急性冠状动脉综合征患者首次发病48 h内BNP浓度与同期测定的左心室舒张末容积、收缩末 容积呈正相关(r =0.42、0.40,均P＜0.01).结论 血清BNP浓度在ACS患者中明显升高,可作为重要的诊断指标之一.ACS患者BNP浓度的升高除了与心脏大小和射血分数相关外,也可能与缺血损伤造成的急性期炎症反应有关.
目的 探討血清腦鈉肽(BNP)與急性冠狀動脈綜閤徵之間的相關性及可能的臨床意義.方法 研究對象為急性心肌梗死患者36例(AMI組),不穩定型心絞痛患者38例(UAP組),穩定型心絞痛患者30例(SAP組),健康體檢者30例(對照組).用酶聯免疫吸附分析法測定所有研究對象的血清BNP、hs-CRP和Lp(a)濃度,併行心髒超聲檢查,測定左心室射血分數(LVEF)、左心室收縮末期容積(LVEDV)及舒張末期容積( LVESV).結果 AMI組的BNP、hs-CRP、Lp(a)水平分彆為(391±136) ng/L、( 16±15) mg/L、(367±191 )mg/L.UAP組分彆為(267±80) ng/L、(11±7) mg/L、(324±171) mg/L.SAP組分彆為(36±21) ng/L、(2±1)mg/L、(191±130) mg/L.對照組分彆為(33±14) ng/L、(1.0±0.4)mg/L、(150±116)mg/L.AMI組和UAP組上述指標與對照組及SAP相比,差異有統計學意義(P＜0.05或P＜0.01).AMI組與SAP組上述指標比較,差異有統計學意義(均P ＜0.05).AMI組與UAP組比較,差異無統計學意義(均P＞0.05).AMI組LVEDV、LVESV、LVEF分彆為(95±19)、(43±9)ml,(0.51±0.08)；UAP組分彆為(93±23)、(42±8)ml,(0.55 ±0.08)；AP組分彆為(86±18)、(32±9)ml,(0.64±0.09)；對照組分彆為(86±18)、(29±9)ml,(0.66±0.09).AMI組、UAP組與SAP組及對照組比較,差異均有統計學意義(P＜0.01).AMI組與UAP組比較,差異無統計學意義(P＞0.05).SAP組與對照組比較,差異無統計學意義(P＞0.05).多元迴歸分析錶明,在ACS患者中,BNP濃度與hs-CRP和Lp(a)呈正相關,(r=0.53,P＜0.01;r=0.543,P＜0.01).BNP濃度與LVEF明顯負相關(r=-0.44,P＜0.01).控製年齡、性彆、體錶麵積後計算兩變量間偏相關繫數.急性冠狀動脈綜閤徵患者首次髮病48 h內BNP濃度與同期測定的左心室舒張末容積、收縮末 容積呈正相關(r =0.42、0.40,均P＜0.01).結論 血清BNP濃度在ACS患者中明顯升高,可作為重要的診斷指標之一.ACS患者BNP濃度的升高除瞭與心髒大小和射血分數相關外,也可能與缺血損傷造成的急性期炎癥反應有關.
목적 탐토혈청뇌납태(BNP)여급성관상동맥종합정지간적상관성급가능적림상의의.방법 연구대상위급성심기경사환자36례(AMI조),불은정형심교통환자38례(UAP조),은정형심교통환자30례(SAP조),건강체검자30례(대조조).용매련면역흡부분석법측정소유연구대상적혈청BNP、hs-CRP화Lp(a)농도,병행심장초성검사,측정좌심실사혈분수(LVEF)、좌심실수축말기용적(LVEDV)급서장말기용적( LVESV).결과 AMI조적BNP、hs-CRP、Lp(a)수평분별위(391±136) ng/L、( 16±15) mg/L、(367±191 )mg/L.UAP조분별위(267±80) ng/L、(11±7) mg/L、(324±171) mg/L.SAP조분별위(36±21) ng/L、(2±1)mg/L、(191±130) mg/L.대조조분별위(33±14) ng/L、(1.0±0.4)mg/L、(150±116)mg/L.AMI조화UAP조상술지표여대조조급SAP상비,차이유통계학의의(P＜0.05혹P＜0.01).AMI조여SAP조상술지표비교,차이유통계학의의(균P ＜0.05).AMI조여UAP조비교,차이무통계학의의(균P＞0.05).AMI조LVEDV、LVESV、LVEF분별위(95±19)、(43±9)ml,(0.51±0.08)；UAP조분별위(93±23)、(42±8)ml,(0.55 ±0.08)；AP조분별위(86±18)、(32±9)ml,(0.64±0.09)；대조조분별위(86±18)、(29±9)ml,(0.66±0.09).AMI조、UAP조여SAP조급대조조비교,차이균유통계학의의(P＜0.01).AMI조여UAP조비교,차이무통계학의의(P＞0.05).SAP조여대조조비교,차이무통계학의의(P＞0.05).다원회귀분석표명,재ACS환자중,BNP농도여hs-CRP화Lp(a)정정상관,(r=0.53,P＜0.01;r=0.543,P＜0.01).BNP농도여LVEF명현부상관(r=-0.44,P＜0.01).공제년령、성별、체표면적후계산량변량간편상관계수.급성관상동맥종합정환자수차발병48 h내BNP농도여동기측정적좌심실서장말용적、수축말 용적정정상관(r =0.42、0.40,균P＜0.01).결론 혈청BNP농도재ACS환자중명현승고,가작위중요적진단지표지일.ACS환자BNP농도적승고제료여심장대소화사혈분수상관외,야가능여결혈손상조성적급성기염증반응유관.
Objective To measure serum B-type natriuretic peptide (BNP),high-sensitive C-reactive protein( hs-CRP)and leptein (a) concentration in patients with acute coronary syndrome,stable angina pectoris and normal healthy subjects ; to investigate the correlation of between BNP and acute coronary syndrome.Methods One hundred and ninety subjects were divided into four groups: 36 patients with acute myocardial infarction (AMI group),38 patients with unstable angina pectoris(UAPgroup) ; 30 patients with stable angina pectoris( SAP group)and 30 normal healthy subjects as the control group.Serum BNP concentration was determined by enzyme linked immuno-asorbent assay Echocardiography was performed in all patients with coronary artery disease to detect left ventricular ejection fraction (LEVF),left ventricular volume parameters and to evaluate ventricular wall-motion.Results The level of serum BNP concentration was high in patients with AMI group (391 ± 136)ng/l and UAPgroup (267 ±80)ng/l than that with SAP group (36 ±21 )mg/L and control group ( 1.0 ±0.4) mg/L,P ＜0.05,respectively.The level of serum concentration hs-CRP was higher in patients with AMI group ( 16 ± 15 ) mg/L and UAPgroup ( 11 ± 7 ) mg/L than that with SAP group (2 ± 1 ) mg/L and control group ( 1.0 ± 0.4 ) mg/L,P ＜ 0.05.The serum level of Lp(a) was higher in UAPgroup (324 ± 171 )mg/L and AMI group (367 ± 191 ) mg/L patients than that in SAP group ( 191 ± 130 ) mg/L patients and control group patients ( 150 ± 116 ) mg/L ( P ＜ 0.01 ).Serum BNP concentration was positively correlated with hs-CRP and Lp(a) (r =0.53,0.54 P ＜0.01 ) and negatively correlated with LVEF.Conclusion The reason of increased serum BNP concentration is not only corrected with the LVEF,but also with the reaction of acute inflamation due to coronary ischemia.
