CAJ | 학술논문

目的：探讨老年冠心病患者血清同型半胱氨酸（Hcy）、N-末端脑钠肽前体（NT-proBNP）水平与冠状动脉病变程度之间的关系及意义。方法选择行冠脉造影检查、年龄≥60岁的冠心病患者129例为研究对象，检测血清 Hcy 及 NT-proBNP 水平，并行冠脉造影检查，造影结果正常24例（对照组）、稳定型心绞痛（SAP 组）28例，非 ST 段抬高型急性冠状动脉综合征（NSTEACS 组）47例、急性 ST 段抬高型心肌梗死（AMI组）30例，采用 Gensini 评分评估冠状动脉病变严重程度，并分析患者血清 Hcy、NT-proBNP 水平与冠脉造影冠状动脉病变程度之间的关系。结果 AMI 组血清 Hcy、NT-proBNP 水平分别为（18．13±8．26）μmol／L、（450.45±230．45）pg／mL，显著高于 NSTEACS 组[（16．96±9．04）μmol／L、（300．96±170．94）pg／mL]、SAP 组[（14．35±5．31）μmol／L、（130．35±85．31）pg／mL]及对照组[（10．19±3．18）μmol／L、（65．19±40．18）pg／mL]（t ＝5．73、3．64；t ＝5．53、3．23；t ＝4．96、3．46；均 P ＜0．05），NSTEACS 组平均 Hcy、NT-proBNP 水平明显高于SAP 组及对照组（t ＝5．06，3．54；t ＝4．79，3．25；均 P ＜0．05），SAP 组平均 Hcy、NT-proBNP 水平高于对照组（t ＝5．89，4．23；P ＜0．05）。冠脉狭窄多支病变、双支病变、单支病变患者血清 Hcy、NT-proBNP 水平分别为（16．13±7．26）μmol／L、（14．35±7．29）μmol／L、（12．67±6．48）μmol／L；（416．45±210．45）pg／mL、（240．54±160．71）pg／mL、（120．76±140．57）pg／mL，三组比较差异均有统计学意义（F ＝13．15、140．25，P ＜0．05、P ＜0.01）。血清 Hcy、NT-proBNP 水平与 Gensini 评分有明显相关性（r ＝0．342，P ＜0．05；r ＝0．962，P ＜0．01）。结论血清 Hcy、NT-proBNP 水平与老年冠心病患者冠状动脉病变程度、狭窄支数呈正相关。测定血清 Hcy、NT-proBNP 水平对于老年冠心病患者的冠脉病变程度和病情的评估具有重要的临床意义。目的：探討老年冠心病患者血清同型半胱氨痠（Hcy）、N-末耑腦鈉肽前體（NT-proBNP）水平與冠狀動脈病變程度之間的關繫及意義。方法選擇行冠脈造影檢查、年齡≥60歲的冠心病患者129例為研究對象，檢測血清 Hcy 及 NT-proBNP 水平，併行冠脈造影檢查，造影結果正常24例（對照組）、穩定型心絞痛（SAP 組）28例，非 ST 段抬高型急性冠狀動脈綜閤徵（NSTEACS 組）47例、急性 ST 段抬高型心肌梗死（AMI組）30例，採用 Gensini 評分評估冠狀動脈病變嚴重程度，併分析患者血清 Hcy、NT-proBNP 水平與冠脈造影冠狀動脈病變程度之間的關繫。結果 AMI 組血清 Hcy、NT-proBNP 水平分彆為（18．13±8．26）μmol／L、（450.45±230．45）pg／mL，顯著高于 NSTEACS 組[（16．96±9．04）μmol／L、（300．96±170．94）pg／mL]、SAP 組[（14．35±5．31）μmol／L、（130．35±85．31）pg／mL]及對照組[（10．19±3．18）μmol／L、（65．19±40．18）pg／mL]（t ＝5．73、3．64；t ＝5．53、3．23；t ＝4．96、3．46；均 P ＜0．05），NSTEACS 組平均 Hcy、NT-proBNP 水平明顯高于SAP 組及對照組（t ＝5．06，3．54；t ＝4．79，3．25；均 P ＜0．05），SAP 組平均 Hcy、NT-proBNP 水平高于對照組（t ＝5．89，4．23；P ＜0．05）。冠脈狹窄多支病變、雙支病變、單支病變患者血清 Hcy、NT-proBNP 水平分彆為（16．13±7．26）μmol／L、（14．35±7．29）μmol／L、（12．67±6．48）μmol／L；（416．45±210．45）pg／mL、（240．54±160．71）pg／mL、（120．76±140．57）pg／mL，三組比較差異均有統計學意義（F ＝13．15、140．25，P ＜0．05、P ＜0.01）。血清 Hcy、NT-proBNP 水平與 Gensini 評分有明顯相關性（r ＝0．342，P ＜0．05；r ＝0．962，P ＜0．01）。結論血清 Hcy、NT-proBNP 水平與老年冠心病患者冠狀動脈病變程度、狹窄支數呈正相關。測定血清 Hcy、NT-proBNP 水平對于老年冠心病患者的冠脈病變程度和病情的評估具有重要的臨床意義。
목적：탐토노년관심병환자혈청동형반광안산（Hcy）、N-말단뇌납태전체（NT-proBNP）수평여관상동맥병변정도지간적관계급의의。방법선택행관맥조영검사、년령≥60세적관심병환자129례위연구대상，검측혈청 Hcy 급 NT-proBNP 수평，병행관맥조영검사，조영결과정상24례（대조조）、은정형심교통（SAP 조）28례，비 ST 단태고형급성관상동맥종합정（NSTEACS 조）47례、급성 ST 단태고형심기경사（AMI조）30례，채용 Gensini 평분평고관상동맥병변엄중정도，병분석환자혈청 Hcy、NT-proBNP 수평여관맥조영관상동맥병변정도지간적관계。결과 AMI 조혈청 Hcy、NT-proBNP 수평분별위（18．13±8．26）μmol／L、（450.45±230．45）pg／mL，현저고우 NSTEACS 조[（16．96±9．04）μmol／L、（300．96±170．94）pg／mL]、SAP 조[（14．35±5．31）μmol／L、（130．35±85．31）pg／mL]급대조조[（10．19±3．18）μmol／L、（65．19±40．18）pg／mL]（t ＝5．73、3．64；t ＝5．53、3．23；t ＝4．96、3．46；균 P ＜0．05），NSTEACS 조평균 Hcy、NT-proBNP 수평명현고우SAP 조급대조조（t ＝5．06，3．54；t ＝4．79，3．25；균 P ＜0．05），SAP 조평균 Hcy、NT-proBNP 수평고우대조조（t ＝5．89，4．23；P ＜0．05）。관맥협착다지병변、쌍지병변、단지병변환자혈청 Hcy、NT-proBNP 수평분별위（16．13±7．26）μmol／L、（14．35±7．29）μmol／L、（12．67±6．48）μmol／L；（416．45±210．45）pg／mL、（240．54±160．71）pg／mL、（120．76±140．57）pg／mL，삼조비교차이균유통계학의의（F ＝13．15、140．25，P ＜0．05、P ＜0.01）。혈청 Hcy、NT-proBNP 수평여 Gensini 평분유명현상관성（r ＝0．342，P ＜0．05；r ＝0．962，P ＜0．01）。결론혈청 Hcy、NT-proBNP 수평여노년관심병환자관상동맥병변정도、협착지수정정상관。측정혈청 Hcy、NT-proBNP 수평대우노년관심병환자적관맥병변정도화병정적평고구유중요적림상의의。
Objective To investigate the relationship between serum homocysteine (Hcy)and N -terminal brain natriuretic peptide (NT -proBNP)and the severity of coronary artery disease in elderly patients with coronary heart disease (CHD).Methods 129 cases of inpatient with concurrent coronary angiography whose age was over 60 years old were selected as the research object.Serum Hcy and NT proBNP level were detected,and parallel coronary angiography were administrated.Angiography was normal in 24 cases (CONTROL group),while 28 cases were stable angina pectoris(SAP group),non ST segment elevation acute coronary artery comprehensive syndrome group (NSTEACS group)had 47 cases,acute ST segment elevation myocardial infarction group had 30 cases(AMI group).was used to The severity of coronary artery lesions were assessed by Gensini score and the relationship be-tween serum Hcy and NT proBNP levels and coronary angiography in the diagnosis of coronary artery disease severity were analyzed.Results AMI group,the mean serum Hcy and NT proBNP levels[(18.13 ±8.26)μmol/L,(450.45 ± 230.45)pg/mL]were significantly higher than those of NSTEACS group [(16.96 ±9.04)μmol/L,(300.96 ± 170.94)pg/mL],SAP group[(14.35 ±5.31)μmol/L,(130.35 ±85.31)pg/mL]and control group[(10.19 ± 3.18)μmol/L,(65.19 ±40.18)pg/mL](t =5.73、3.64;t =5.53、3.23;t =4.96、3.46;P <0.05).In NSTEACS group,average of Hcy and NT proBNP levels were significantly higher than those of SAP group and control group (t =5.06,3.54;t =4.79,3.25;P <0.05).In SAP group,the average of Hcy and NT proBNP levels were higher than those in the control group (t =5.89,4.23;P <0.05).The levels of serum Hcy and NT -proBNP in patients with cor-onary artery stenosis,double vessel disease and single vessel disease were(16.13 ±7.26)mol/L,(7.29 ±14.35)mol/L, (12.67 ±6.48)pg/mL,(210.45 ±416.45)pg/mL and (160.71 ±140.57)pg/mL,the difference was statistically significant (F =140.25,F =13.15;P <0.05,P <0.01).The levels of serum Hcy and NT -proBNP were signifi-cantly correlated with Gensini score (r =0.342,P <0.05;r =0.962,P <0.01).Conclusion Correlation between serum Hcy,NT -proBNP levels in elderly patients with coronary heart disease and the severity of coronary artery disease and stenosis count is positive.Determining the levels of serum Hcy and NT -proBNP in patients with coronary heart disease and the assessment of the severity of the disease has important clinical significance.