血浆B型利钠肽、尿酸和颈动脉内膜-中层厚度与冠状动脉病变严重程度的相关性

目的:探讨冠心病患者冠状动脉病变程度与血浆B型利钠肽（BNP）、颈动脉内膜-中层厚度（IMT）和尿酸（UA）的相关性。方法:经冠状动脉造影证实的冠状动脉粥样硬化性心脏病106例作为冠心病组，同期住院经冠状动脉造影阴性80例为对照组。2组均排除严重肝、肾、肺、脑及其他心脏病。冠心病组按冠状动脉病变程度分为1支病变组45例，2支病变组31例和3支病变组30例。分析冠心病病变程度和颈动脉粥样硬化及血浆BNP、UA水平的相关性。分析不同冠状动脉病变程度组颈动脉IMT、血浆BNP、UA水平的相关性。结果:冠心病组IMT、血浆BNP、UA水平均明显高于对照组（P<0.01），且1、2和3支病变组IMT、血浆BNP、UA水平均呈逐级增高趋势（P<0.01）。3支病变组颈动脉IMT均显著高于1支和2支病变组（P<0.01），2支病变组颈动脉IMT亦明显高于1支病变组（P<0.01）。结论:颈动脉IMT、血浆BNP和UA水平与冠状动脉病变程度具有相关性，联合测定颈动脉IMT、BNP和UA水平可预测冠状动脉的病变程度。

The correlations between the severity of coronary artery lesions and plasma B-type natriuretic peptide,uric acid and carotid intima-middle thickness

Objective:To study the correlations of coronary artery disease(CHD)injury degree in CHD patients and carotid intima -middle thickness(IMT),plasma B-type natriuretic peptide(BNP) and uric acid(UA) levels. Methods:One hundred and six CHD cases who confirmed by coronary angiography were selected as CHD group,80 cases with negative results by coronary angiography were as control group. All patients in the two groups were ruled out severe liver,kidney,lung,brain and other heart disease. According to the degree of coronary artery lesions,the patients in CHD group were divided into single lesion group of 45 cases,2 lesions group of 31 cases and 3 lesions group of 30 cases. The correlations of the pathological change degree of coronary artery,carotid atherosclerosis and the levels of plasma BNP and UA were analyzed. The correlations of coronary artery lesions injury degree and carotid IMT,plasma BNP,UA levels among the different groups were analyzed statistically. Results:IMT, the levels of plasma BNP and UA in CHD group were obviously higher than those in control group(P<0. 01),with the number increase of coronary artery lesion,there showed an increasing trend of IMT,plasma BNP and UA levels(P<0. 01). Carotid IMT in 3 lesions group was significantly higher than that in single lesion and 2 lesions groups(P<0. 01),carotid IMT in 2 lesions group was obviously higher than that in single lesion group(P<0. 01). Conclusions:Carotid IMT,plasma BNP,UA levels were correlated with coronary artery disease degree,the combined determination of carotid IMT and plasma BNP,UA levels can predict the injury extent of coronary artery lesions.