目的 探讨在心功能正常情况下不稳定型心绞痛(unstable angina pectoris,UAP)与稳定型心绞痛(stable angina pectoris,SAP)患者血浆N-末端脑钠肽前体(NT-proBNP)浓度的差异及UAP患者血浆NT-proBNP浓度与肌钙蛋白Ⅰ(cTnⅠ)的相关性及其临床意义. 方法 选择住院冠心病心绞痛患者116例,其中SAP 54例,UAP组62例,UAP组中cTnⅠ阳性者32例,cTnⅠ阴性者30例,正常对照组35例,测定每位患者的血浆NT-proBNP、cTnⅠ水平,比较不同组别NT-proBNP浓度及分析UAP患者NT-proBNP与cTnⅠ的关系. 结果 UAP患者血浆NT-proBNP浓度[146.55(53.65,772.55) pg/ml]高于SAP组[47.50(19.23,87.35) pg/ml]和对照组[33.38(14.07,66.60) pg/ml],差异有统计学意义(P＜0.01),SAP组血浆NT-proBNP浓度与对照组比较,差异无统计学意义(P＞0.05);UAP患者中cTnⅠ阳性组血浆NT-proBNP浓度[646.86(127.85,1 181.63) pg/ml]高于cTnⅠ阴性组[91.50(26.54,145.83) pg/ml],差异有统计学意义(P＜0.01),UAP患者血浆NT-proBNP浓度与cTnⅠ浓度呈正相关(r=0.57,P＜0.05). 结论 UAP患者血浆NT-proBNP浓度增高,并与cTnⅠ浓度呈正相关;心肌缺血是NT-proBNP释放的重要刺激因素之一,NT-proBNP与心肌缺血的严重程度有关;测定NT-proBNP有利于发现心功能正常但处于高风险的患者,使患者能得到早期干预,降低心血管事件发生的风险.%Objective To investigate the clinical significances of plasma level of N-terminal ProB-type natriuretic peptide (NT-proBNP) between unstable angina pectoris(UAP) and stable angina pectoris (SAP) and correlation between plasma cardiac troponin Ⅰ (cTnⅠ) and NT-proBNP in patients with UAP.Methods 116 patients with angina pectoris were enrolled in this study,including 54 SAP,62 UAP.62 UAP patients were divided into cTnⅠ(+) group (n=32) and 30 cTnⅠ(-) group (n=30),and 30 healthy persons were selected as control.The plasma level of NT-proBNP and cTnⅠ of all cases were measured and compared in the three groups and the correlation between cTnⅠ and NT-proBNP in UAP patients with cTnⅠ (+) were analyzed.Results Plasma levels of NT-proBNP were 146.55 (53.65,772.55) pg/ml,47.50 (19.23,87.35) pg/ml,33.38(14.07,66.60) pg/ml in the patients with UAP,SAP and control group respectively,the level of NT-proBNP in UAP group was significantly higher than that in SAP or control group(P＜0.01) ; there were no significant difference in NT-proBNP level between SAP and control group (P ＞ 0.05).Plasma levels of NT-proBNP were 646.86(127.85,1181.63) pg/ml,91.50(26.54,45.83)pg/ml in cTnⅠ(+) and cTnⅠ (-) group respectively,the plasma level of NT-proBNP in the UAP group whose cTnⅠ (+) was significantly higher than those UAP patients whose cTnⅠ (-) (P＜0.01),NT-proBNP level were positively correlated with cTnⅠ in UAP(r=0.57,P＜0.05).Conclusions The plasma level of NT-ProBNP in UAP is increased and it positively correlated with cTnⅠ.All of the patients with coronary heart disease (CHD) should measure the plasma NT-proBNP to find out the patients at the high risk while whose heart function is normal,and further to receive the early intervention,and reduce the incidence of cardiovascular risk.
展开▼
