摘要
目的探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血浆B型钠尿肽(brain natriuretic peptide,BNP)与冠状动脉病变严重程度的关系。方法回顾性分析首都医科大学附属北京天坛医院心脏重症监护病房2019年1~5月连续收治的115例ACS患者,根据冠脉造影结果,应用SYNTAX评分评定冠状动脉病变严重程度,根据SYNTAX评分将ACS患者分为两组,即冠状动脉轻度病变组(SYNTAX评分≤22)和中重度病变组(SYNTAX评分≥23),分别检测两组患者血浆BNP水平,分析其与SYNTAX评分的相关性及其对冠脉严重程度的预测作用。结果在ACS患者中,冠状动脉中重度病变组血浆中BNP水平明显高于轻度病变组(411.13±357.40pg/ml vs 151.68±191.09pg/ml,P=0.000),血浆BNP水平与SYNTAX评分呈正相关(r=0.465,P=0.000),冠状动脉病变的严重程度随着BNP的升高而增加。进一步分析显示,两组患者之间冠状动脉血管病变支数的比例差异有统计学意义,冠状动脉中重度病变组患者三支病变的比例显著高于轻度病变组患者(P<0.05)。在多因素Logistic回归分析中显示,BNP仍然是ACS患者冠状动脉中重度病变的独立预测因子(OR=1.51,95%CI:1.30~2.61,P=0.000)。结论在ACS患者中,血浆BNP水平与冠状动脉病变严重程度呈正相关,血浆BNP水平是冠状动脉中重度狭窄的独立预测因素。
Objective To investigate the correlation between the level of brain natriuretic peptide(BNP)and the severity of coronary atherosclerosis in patients with acute coronary syndrome(ACS).Methods A retrospective study was performed on 115 patients with ACS received in Beijing Tiantan Hospital,Capital Medical University from January 2019 to May 2019.SYNTAX score were calculated according to the results of coronary angiography,and the patients with ACS were divided into two groups:low SYNTAX score(≤22),intermediate-high SYNTAX score(≥23),and serum BNP levels were measured in all patients.The correlation between BNP and SYNTAX score was analyzed.Results The level of plasma BNP was significantly higher in the intermediate-high SYNTAX score group in comparison to the low SYNTAX score group(411.13±357.40pg/ml vs 151.68±191.09pg/ml,P=0.000).Correlation analysis showed that BNP results were positively correlated with SYNTAX score(r=0.465,P=0.000).Patients with intermediate-high SYNTAX score had significantly higher rate of multi-vessel disease.In multivariate Logistic analysis,BNP remained an independent predictor of intermediate-high SYNTAX score(OR=1.51,95%CI:1.30-2.61,P=0.000).Conclusion The plasma BNP level is positively related to coronary artery severity of lesion and SYNTAX score in patients with ACS.Plasma BNP level is an independent predictor of moderate to severe coronary stenosis.
作者
穆利英
熊筱伟
郭彩霞
孟帅
杜凤和
Mu Liying;Xiong Xiaowei;Guo Caixia(Department of Cardiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100160,China)
出处
《医学研究杂志》
2020年第4期135-138,144,共5页
Journal of Medical Research
