稳定型心绞痛及急性冠脉综合征患者脑钠肽浓度的变化和意义

目的探讨冠状动脉粥样硬化性心脏病稳定型心绞痛(SAP)及急性冠脉综合征(ACS)患者血浆脑钠肽(BNP)浓度的变化及其临床意义。方法采用荧光免疫抗原抗体结合方法测定22例冠脉造影正常、心功能正常者,15例SAP患者及64例ACS患者静脉血BNP浓度。结果ACS组血浆BNP浓度(397.57±472.12)高于SAP组(38.39±36.50)及对照组(22.15±19.90)(P<0.005,P<0.005);心梗(AMI)亚组BNP浓度(460.55±518.90)高于不稳定型心绞痛(UAP)亚组(208.62±203.18)(P<0.01)。SAP组和对照组BNP浓度差异无统计学意义(P>0.05)。结论ACS患者血浆BNP浓度明显升高,心梗较不稳定型心绞痛患者变化更为明显,说明心肌缺血是BNP释放的重要刺激因素。

Levels and significance of brain natriuretic peptide in patients with stable angina pectoris and acute coronary syndrome

Objective To explore the variation of brain natriuretic peptide and in patients with stable angina pectoris (SAP) and acute coronary syndrome (ACS). Methods Plasma BNP in 64 ACS patients , 15 SAP patients and 22 healthy controls with normal coronary artery angiogram (CAG) and cardiac function(control group) was tested by fluoroimmunoassay. ACS patients were divided into unstable angina pectoris (UAP) group and myocardial infarction (MI) group. Results The plasma BNP level in ACS group was significantly higher than that in SAP group and control group (P<0.005, P<0.005 respectively).The same was true when the level of BNP in MI group and UAP group was compared to that in SAP group and control group seperately (P<0.005, P<0.005 and P<0.005, P<0.01 respectively).The plasma BNP level in MI group was significantly higher than that in UAP group. But there was no significant difference between SAP group and control group (P>0.05). Conclusion Plasma BNP level increased significantly in patients with ACS. It seems more prominent in patients with MI. Ischemia is an important stimulus for BNP release.