冠心病患者血浆BNP及白细胞计数测定的临床意义

目的 观察冠心病（CHD）患者血浆BNP及外周血白细胞计数（WBC）与冠脉病变程度的关系,探寻冠心病的发病原因.方法 对入选的冠心病患者（120例）和正常对照组（33例）应用免疫荧光法检测血浆BNP,应用全自动血细胞计数仪进行白细胞计数.入选病例根据临床症状分为急性心肌梗死（AMI组）50例,不稳定型心绞痛（UAP组）38例,稳定型心绞痛（SAP组）32例;根据冠脉造影分为单支病变组54例、双支病变组39例和多支病变组27例.应用方差分析研究BNP及白细胞计数在各组中的分布情况,用直线相关分析BNP与WBC的相关性.结果 （1）AMI组BNP水平明显高于UAP组、SAP组和对照组（P〈0.01）,UAP组和SAP组BNP水平明显高于对照组（均P〈0.01）.多支病变组BNP高于单支、双支和正常对照组（P〈0.01）.（2）AMI组WBC明显高于UAP组、SAP组和对照组（P〈0.01）,UAP组和SAP组WBC明显高于对照组（均P〈0.01）.多支病变组WBC 高于单支、双支和正常对照组（P〈0.01）.（3）相关性分析显示BNP与WBC呈显著正相关（r=0.412,P＜0.05）.结论 冠心病患者血浆BNP和WBC明显升高,且二者具有显著相关性,可为危险分层和炎症程度的判断提供重要信息.

The clinical significance of BNP and leukocyte counts determination in patients with coronary heart disease

Objective To investigate the relationship between B - type natriuretie peptide, leukocyte counts and coronary artery lesions as well as try to find the possible cause of coronary heart disease. Methods A total of 120 patients with CHD, including 50 cases of acute myocardial infarction（AMI）, 38 cases of angina pectoris（UAP） and 32 cases of angina pectofis（ SAP）, and 33 normal subjects without CHD diagnosed by CAG served as the control group, were subjected to detect the plasma levels of BNP and WBC. Among the 120 cases, the number of patient with single, double and three vessel lesion diagnosed by CAG were 54, 39, 27 respectively. The association of the BNP level and WBC were analyzed at meantime. Results The plasma levels of BNP and WBC in AMI, UAP, SAP and the control group were different. Those in AMI group were higher than those in SAP group, UAP group and control group（P 〈 0.01）. The plasma levels of BNP and WBC in single, double, and three vessel lesion group were higher than those in control group（P 〈 0.01 ）. The plasma levels of BNP were obviously correlated with WBC（r= 0.412, P〈 0.05）. Conclusion Plasma levels of BNP and WBC are elevated in patients with CHD and BNP is associated with WBC. Assay for plasma levels of the BNP and WBC can carry important information for acute coronary syndrome risk stratification and the severity of infection.