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目的:观察不同程度冠状动脉(冠脉)病变患者的血浆N-末端脑钠肽前体(NT-proBNP)水平的变化,探讨血浆NT-proBNP水平与冠脉病变严重程度的关系。方法:入选180例均经冠脉造影术确诊冠心病的患者,根据冠脉病变的程度分为单支组、双支组、多支组;另选30例非冠心病者作对照组。测定各组血浆NT-proB-NP水平和左室射血分数。结果:对照组、单支、双支和多支组血浆NT-proBNP水平分别为(65.53±5.73)、(255.84±28.37)、(442.78±86.43)、(940.00±215.35)ng/L;各冠脉病变组的明显高于对照组(P<0.01),且随冠脉病变支数增加而增高。血浆NT-proBNP水平与冠脉病变血管支数(r=0.815,P<0.01)及冠脉造影Gensini积分(r=0.870,P<0.01)呈显著正相关,与LVEF(r=-0.215,P<0.05)呈负相关,多元逐步回归分析显示血浆NT-proBNP水平对冠脉病变程度有独立的预测价值。结论:血浆NT-proBNP水平可以反映冠脉病变程度。
Objective: To observe the changes of plasma NT-proBNP level in patients with coronary artery disease with different degrees of severity and to investigate the relationship between plasma NT-proBNP level and the severity of coronary artery disease. Methods: 180 patients with coronary heart disease confirmed by coronary angiography were enrolled. According to the degree of coronary artery disease, they were divided into single branch group, double branch group and multiple branch group. Another 30 non-coronary heart disease patients were selected as control group. The plasma levels of NT-proB-NP and left ventricular ejection fraction were determined. Results: The plasma levels of NT-proBNP were (65.53 ± 5.73), (255.84 ± 28.37), (442.78 ± 86.43) and (940.00 ± 215.35) ng / L in the control group, The group of pathological changes was significantly higher than the control group (P <0.01), and increased with the number of coronary lesions. The level of NT-proBNP in plasma was positively correlated with the number of vessels in coronary artery (r = 0.815, P <0.01) and Gensini score in coronary angiography (r = 0.870, P <0.01) <0.05), and multivariate stepwise regression analysis showed that plasma NT-proBNP level had independent predictive value on the degree of coronary artery lesion. Conclusion: The level of plasma NT-proBNP can reflect the degree of coronary artery lesion.