CAJ | 학술논문

目的探讨急性冠状动脉综合征(ACS)患者血浆B型尿钠肽(BNP)水平与冠状动脉病变Gensini积分的关系.方法入选309例在首都医科大学附属北京安贞医院特需医疗科住院的ACS患者,其中急性心肌梗死患者66例,不稳定型心绞痛患者243例.选取同期因胸闷等症状就诊但冠状动脉造影正常的70例患者作为对照组.所有患者均用化学发光微粒子免疫检测方法测定血浆BNP水平,并行冠状动脉造影,按冠状动脉病变支数分为单支病变(132例)、双支病变(115例)、三支病变组(62例);根据冠状动脉病变Gensini分值不同分为Gensini评分＜20分组(68例),Gensini评分20～ 40分组(128例),Gensini评分＞40分组(1 13例).对于ACS患者血浆BNP水平与冠状动脉病变Gensini积分的关系进行分析.结果 ACS患者血浆BNP水平明显高于对照组[120.0(54.6,226.7) ng/L比18.0(14.0,28.6) ng/L] (P＜0.0l).血浆BNP水平在冠状动脉病变3支病变组明显高于双支病变组及单支病变组[(269±197) ng/L比(159 ±88)、(82 ±54) ng/L](均P＜0.01);在冠状动脉病变Gensini评分＞40分组明显高于20 ～ 40分组及＜20分组[(214±126)ng/L比(122 ±80)、(88±56) ng/L](均P＜0.01).血浆BNP水平与冠状动脉Gensini积分呈正相关(r=0.534,P＜0.01).结论血浆BNP水平与ACS患者冠状动脉病变程度密切相关,能在一定程度上反映冠状动脉病变的严重程度.
목적 탐토급성관상동맥종합정(ACS)환자혈장B형뇨납태(BNP)수평여관상동맥병변Gensini적분적관계.방법 입선309례재수도의과대학부속북경안정의원특수의료과주원적ACS환자,기중급성심기경사환자66례,불은정형심교통환자243례.선취동기인흉민등증상취진단관상동맥조영정상적70례환자작위대조조.소유환자균용화학발광미입자면역검측방법측정혈장BNP수평,병행관상동맥조영,안관상동맥병변지수분위단지병변(132례)、쌍지병변(115례)、삼지병변조(62례);근거관상동맥병변Gensini분치불동분위Gensini평분＜20분조(68례),Gensini평분20～ 40분조(128례),Gensini평분＞40분조(1 13례).대우ACS환자혈장BNP수평여관상동맥병변Gensini적분적관계진행분석.결과 ACS환자혈장BNP수평명현고우대조조[120.0(54.6,226.7) ng/L비18.0(14.0,28.6) ng/L] (P＜0.0l).혈장BNP수평재관상동맥병변3지병변조명현고우쌍지병변조급단지병변조[(269±197) ng/L비(159 ±88)、(82 ±54) ng/L](균P＜0.01);재관상동맥병변Gensini평분＞40분조명현고우20 ～ 40분조급＜20분조[(214±126)ng/L비(122 ±80)、(88±56) ng/L](균P＜0.01).혈장BNP수평여관상동맥Gensini적분정정상관(r=0.534,P＜0.01).결론 혈장BNP수평여ACS환자관상동맥병변정도밀절상관,능재일정정도상반영관상동맥병변적엄중정도.
Objective To explore the relation between plasma B-type natriuretic peptide (BNP) and Gensini score in patients with acute coronary syndrome(ACS).Methods There were 309 patients who were diagnosed of ACS (66 patients with acute myocardial infarction,243 patients with unstable angina) by coronary artery angiography.70 cases with angiographically normal coronary arteries were as control group.Plasma BNP levels were detected and calculated by Gensini score.Patients was divided based on the coronary lesions.The patients with ACS were divided into one-artery lesion group (132 cases),two-artery lesion group (115 cases) and three-artery lesion group (62 cases).The patients with ACS were also divided into Gensini score ＜ 20 group (68 cases),Gensini score 20-40 group (128 cases) and Gensini score ＞40 group (113 cases).The relation between the plasma B-type natriuretic peptide and Gensini score were analyzed.Results Serum level of BNP was significantly higher in patients with ACS than in the control group [120.0 (54.6,226.7) ng/L vs 18.0(14.0,28.6) ng/L,P ＜ 0.01].Serum levels of BNP in three-artery lesion group were significantly higher than those in the two-artery lesion group and one-artery lesion group [(269 ± 197) ng/L vs (159 ± 88),(82 ± 54) ng/L,P ＜ 0.01].Serum levels of BNP in Gensini score ＞40 group was significantly higher than that in the Gensini score 20-40 group and Gensini score ＜20 group[(214 ± 126) ng/L vs (122 ± 80),(88 ±56) ng/L,P ＜0.01].Correlation test showed that level of serum BNP and Gensini score were correlated (r =0.534,P ＜ 0.01).Conclusion Plasma levels of BNP are closely related with the severity of coronary artery lesions,and detection of plasma BNP levels can reflect the severity of coronary artery disease.