CAJ | 학술논문

目的：探讨血浆脑钠肽（BNP）水平和中心动脉压与冠状动脉病变程度的相关性。方法选取该院心内科2011年3～6月住院的非心力衰竭冠心病患者150例，符合冠心病的临床诊断标准且冠状动脉造影结果呈阳性。根据血压情况将患者分成高血压组（n＝90）和非高血压组（n＝60）。冠状动脉造影前用ELISA法测定各组血浆BNP水平，冠状动脉造影后计算各组冠状动脉病变支数和评分。所有病例在造影前后采用无创测量法测量中心动脉压，记录收缩压（SBP）和舒张压（DBP）平均值及中心动脉压脉压差（PP）。通过Logistic回归分析PP与BNP之间的相关性。结果高血压组血浆BNP水平明显高于非高血压组（P＜0．05）。冠状动脉双支病变组和三支病变组的SBP较正常组显著升高（P＜0．05）。冠状动脉三支病变的PP较正常组显著升高（P＜0．05）。冠状动脉三支、双支和单支病变的血浆BNP水平都明显高于冠状动脉正常组（P＜0．05）。PP影响因素的Lo-gistic回归分析显示，PP与冠状动脉病变支数、病变评分、左心室射血分数、BNP关系密切；PP与冠状动脉病变支数、病变评分和BNP复相关系数为0．91，其线性模型为PP＝0．543病变支数＋0．656病变评分＋0．864 BNP。结论 PP是冠状动脉狭窄发生发展的危险因素。BNP可以作为冠状动脉狭窄程度的血浆标志物。
목적：탐토혈장뇌납태（BNP）수평화중심동맥압여관상동맥병변정도적상관성。방법선취해원심내과2011년3～6월주원적비심력쇠갈관심병환자150례，부합관심병적림상진단표준차관상동맥조영결과정양성。근거혈압정황장환자분성고혈압조（n＝90）화비고혈압조（n＝60）。관상동맥조영전용ELISA법측정각조혈장BNP수평，관상동맥조영후계산각조관상동맥병변지수화평분。소유병례재조영전후채용무창측량법측량중심동맥압，기록수축압（SBP）화서장압（DBP）평균치급중심동맥압맥압차（PP）。통과Logistic회귀분석PP여BNP지간적상관성。결과고혈압조혈장BNP수평명현고우비고혈압조（P＜0．05）。관상동맥쌍지병변조화삼지병변조적SBP교정상조현저승고（P＜0．05）。관상동맥삼지병변적PP교정상조현저승고（P＜0．05）。관상동맥삼지、쌍지화단지병변적혈장BNP수평도명현고우관상동맥정상조（P＜0．05）。PP영향인소적Lo-gistic회귀분석현시，PP여관상동맥병변지수、병변평분、좌심실사혈분수、BNP관계밀절；PP여관상동맥병변지수、병변평분화BNP복상관계수위0．91，기선성모형위PP＝0．543병변지수＋0．656병변평분＋0．864 BNP。결론 PP시관상동맥협착발생발전적위험인소。BNP가이작위관상동맥협착정도적혈장표지물。
Objective To investigate the correlation between plasma brain natriuretic peptide (BNP) ,central aortic systolic pres-sure with the degree of coronary artery lesion .Methods One hundred and fifty patients with coronary artery disease ,positive coro-nary angiographic results and without heart failure in the cardiological department of this hospital from March to June 2011 were selected and divided into the hypertension group (n=90) and the non-hypertension group(n=60) according to the blood pressure . The plasma BNP before angiography was detected by ELISA .The coronary lesion vessels and clinical scores were assessed after an-giography .The central aortic pressure before angiography was measured by the noninvasive measurement method and the diastolic blood pressure(DBP) ,systolic blood pressure(SBP) and pulse pressure(PP)were recorded .The correlation between PP and BNP was analyzed by Logistic regression .Results The plasma BNP concentration in the hypertension group was significantly higher than that in the non-hypertension group(P<0 .05) .The SBP level in 2 vessels ,3 vessels was significantly higher than that in the momal coronary group(P<0 .05) ,the PP in 3 vessels was significantly higher than that in the momal coronary group (P<0 .05) . The BNP level in 3 vessels ,2 vessels and single vessel of coronary artery lesion was significantly higher than that in the normal cor-onary artery group(P<0 .05) .The Logistic regression analysis on the PP influencing factors found that PP was closely related with the number of coronary artery lesion vessels ,lesion score ,LVEF and BNP ;the multiple correlation coefficient between PP with the number of coronary artery lesion vessels ,lesion score and BPN was 0 .91 ,its linear model was PP=0 .543 lesion vessels number +0 .656 lesion score + 0 .864 BNP .Conclusion PP of the central aortic pressure is a risk factor for the development and progress of coronary artery stenosis occurrence .BNP may be used as a plasma marker of the degree of coronary artery stenosis .