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目的观察不同类型冠心病患者血浆B型钠尿肽(BNP)浓度的改变及其与左心室射血分数(LVEF)的相关性,并探讨其临床意义。方法把经冠状动脉造影证实为冠心病的患者112例作为观察对象,按临床类型分为:急性心肌梗死(AM I)组(38例),不稳定型心绞痛(UAP)组(50例),稳定型心绞痛(SAP)组(24例);对照组为非冠心病患者22例。采用双抗夹心免疫荧光法测定血浆B型钠尿肽(BNP)浓度,并行超声心动图检查评价心功能。比较不同组BNP浓度的差异以及各组BNP水平与LVEF的相关性,并观察AM I组心血管事件发生者与未发生者血浆BNP浓度的差异。结果AM I组BNP水平明显高于UAP、SAP和对照组(P<0.01),UAP组BNP水平明显高于SAP组和对照组(P<0.01),SAP和对照组BNP水平无明显差异(P>0.05)。AM I组和UAP组LVEF与血浆BNP水平均呈明显负相关,AM I组发生心血管事件的患者血浆BNP浓度明显高于未发生者(P<0.05)。结论不同类型冠心病患者血浆BNP浓度存在差异,血浆BNP浓度与LVEF有明显的负相关,血浆BNP浓度可预测AM I近期预后。
Objective To investigate the changes of plasma B-type natriuretic peptide (BNP) and its correlation with left ventricular ejection fraction (LVEF) in patients with different types of coronary heart disease and to investigate its clinical significance. Methods One hundred and twelve patients confirmed by coronary angiography as coronary heart disease were divided into three groups according to clinical types: AMI group (38 cases), unstable angina pectoris group (50 cases), AMI group Patients in stable angina pectoris (SAP) group (24 cases) and control group (22 cases) were non-coronary heart disease patients. The plasma concentration of B-type natriuretic peptide (BNP) was measured by double-antibody sandwich immunofluorescence. Cardiac function was evaluated by echocardiography. The difference of BNP concentration in different groups and the correlation between BNP level and LVEF in each group were also observed. The difference of plasma BNP concentration between AMI group and non-cardiovascular group was also observed. Results The level of BNP in AMI group was significantly higher than that in UAP, SAP and control groups (P <0.01). The level of BNP in UAP group was significantly higher than that in SAP group and control group (P <0.01) > 0.05). There was a significant negative correlation between LVEF and plasma BNP levels in patients with AM I and UAP, and plasma BNP levels in patients with AM I and those with cardiovascular events were significantly higher than those without AMI (P <0.05). Conclusions There are differences in the plasma BNP concentrations between different types of CHD patients. There is a clear negative correlation between plasma BNP concentration and LVEF. The plasma BNP concentration can predict the recent AMI prognosis.