CAJ | 학술논문

目的：探讨氨基末端脑钠肽前体与冠状动脉病变程度的相关性。方法连续入选2005年3月至2011年3月于我院接受冠状动脉造影（coronary angiography， caG）检查的患者共1394例，根据患者入院后应用酶联免疫吸附法检查血中氨基末端脑钠肽前体水平，结果分为氨基末端脑钠肽前体正常（<140pg/ml)轻中度升高(140-200pg/ml)和重度升高(>200pg/ml)三组。其中，氨基末端脑钠肽前体正常的380例(104±22.4pg/ml)，轻中度升高的226例(188±33.6pg/ml)以及重度升高的353例(489.4±56.7pg/ml)。比较各组患者的临床特点以及冠状动脉病变严重程度。结果各组患者在性别比例、年龄、体脂肪健康指数（BMi）、急性冠脉综合征患病比例、高血压病史、糖尿病史、心力衰竭病史、脑血管病史、收缩压、糖化血红蛋白、甘油三酯、胆固醇和低密度脂蛋白等方面的差异均有统计学意义（P<0.05）。氨基末端脑钠肽前体重度升高患者冠状动脉病变严重程度的比例高于其余两组，差异有显著统计学意义，2支病变（P=0.001）、3支病变（P=0.001）、左主干病变（P=0.001）、lad近端病变（P=0.027）以及开口病变（P=0.005）所占比例显著升高。多因素分析，校正其他因素后，氨基末端脑钠肽前体是冠状动脉病变严重程度的独立预测因素（rr2.33，95%ci 1.74-5.10）。结论氨基末端脑钠肽前体与冠状动脉病变严重程度有正相关性，可作为评价冠状动脉病变程度的指标。
목적：탐토안기말단뇌납태전체여관상동맥병변정도적상관성。방법련속입선2005년3월지2011년3월우아원접수관상동맥조영（coronary angiography， caG）검사적환자공1394례，근거환자입원후응용매련면역흡부법검사혈중안기말단뇌납태전체수평，결과분위안기말단뇌납태전체정상（<140pg/ml)경중도승고(140-200pg/ml)화중도승고(>200pg/ml)삼조。기중，안기말단뇌납태전체정상적380례(104±22.4pg/ml)，경중도승고적226례(188±33.6pg/ml)이급중도승고적353례(489.4±56.7pg/ml)。비교각조환자적림상특점이급관상동맥병변엄중정도。결과각조환자재성별비례、년령、체지방건강지수（BMi）、급성관맥종합정환병비례、고혈압병사、당뇨병사、심력쇠갈병사、뇌혈관병사、수축압、당화혈홍단백、감유삼지、담고순화저밀도지단백등방면적차이균유통계학의의（P<0.05）。안기말단뇌납태전체중도승고환자관상동맥병변엄중정도적비례고우기여량조，차이유현저통계학의의，2지병변（P=0.001）、3지병변（P=0.001）、좌주간병변（P=0.001）、lad근단병변（P=0.027）이급개구병변（P=0.005）소점비례현저승고。다인소분석，교정기타인소후，안기말단뇌납태전체시관상동맥병변엄중정도적독립예측인소（rr2.33，95%ci 1.74-5.10）。결론안기말단뇌납태전체여관상동맥병변엄중정도유정상관성，가작위평개관상동맥병변정도적지표。
Objective to investigate the correlation of amino terminal brain natriuretic peptide precursor and degree of coronary artery lesion.Methods a total of 1394 cases of patients accepting coronary angiography (, caG) examination were continuously enrolled from March 2005 to March 2011 in our hospital. they were divided into normal amino terminal brain natriuretic peptide precursor group (< 140 pg/ml), mild-to-moderate elevated group (140-200 pg/ml) and severe rise group (> 200 pg/ml), according to the amino terminal brain natriuretic peptide precursor levels in the blood checked by enzyme-linked immunosorbent method after admission, with 380 cases of normal level of amino terminal brain natriuretic peptide precursor (104±22.4pg/ml), 226 cases of mild-to-moderate rise (188 ± 33.6 pg/ml) and severe rise in 353 cases ( 489.4±56.7pg/ml). the clinical characteristics and severity of coronary artery lesions were compared between groups.ResultsThere were signiifcant differences in these terms of patients including sex ratio, age, body fat index (BMi), the proportion of acute coronary syndrome, history of hypertension, diabetes, heart failure, cerebrovascular diseases, systolic blood pressure, Hba1c, triglyceride, cholesterol and low density lipoprotein(P < 0.05). in the group of patients with severely elevated amino terminal brain natriuretic peptide precursor, the proportion of the degree of severity in coronary artery lesions was higher than that of the rest of the two groups, with statistically signiifcant difference. Also, the proportion of 2 lesions (P = 0.001), 3 lesions (P = 0.001), the left main lesion (P= 0.001), proximal lad lesions (P = 0.027) and ostial lesions in this group were signiifcantly increased (P = 0.005). By multiple factors analysis and correction for other factors, we found that amino terminal brain natriuretic peptide precursor was an independent predictor for severity of coronary artery lesion (rr2.33, 95% ci 1.74 to 1.74).Conclusion: the amino terminal brain natriuretic peptide precursor is positive correlated with severity of pathological changes in coronary artery. therefore, it can be used as evaluation index of coronary artery lesion severity.