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目的:研究冠心病患者脑型利钠肽(BNP)浓度的变化,探讨BNP对急性冠脉综合征(ACS)危险分层的价值。方法:用酶联免疫吸附法(ELISA)检测了78例经冠脉造影证实的ACS患者[38例急性心肌梗死(AMI),40例不稳定性心绞痛(UAP)]、42例稳定性心绞痛(SAP)及30例非冠心病健康对照组的BNP的水平。随访30d,观察终点为AMI新发或再发、出现或心衰恶化和心源性猝死。结果:血浆BNP在AMI组(197.57±72.12ng/L)和UAP组(120.10±51.11ng/L)明显高于SAP组(38.39±36.50ng/L)及对照组(28.09±21.34ng/L)(P<0.05)。SAP组和对照组BNP浓度差异无统计学意义(P>0.05),AMI组和UAP组间有统计学意义(P<0.05)。BNP≤80ng/L组较BNP>80ng/L组有更高的AMI新发或再发率、心衰发生或恶化率。结论:BNP对ACS患者近期预后有重要的临床价值,可作为危险分层的指标。
Objective: To study the changes of brain natriuretic peptide (BNP) in patients with coronary heart disease and to explore the value of BNP in the risk stratification of acute coronary syndrome (ACS). Methods: Seventy eight ACS patients confirmed by coronary angiography (38 AMI, 40 unstable angina pectoris (UAP)] and 42 patients with stable angina pectoris (UAP) were detected by enzyme linked immunosorbent assay (ELISA) SAP) and 30 non-CHD healthy controls. After 30 days of follow-up, the end point of the study was new or recurrent AMI, worsening of heart failure and sudden cardiac death. Results: Plasma BNP level in AMI group (197.57 ± 72.12ng / L) and UAP group (120.10 ± 51.11ng / L) was significantly higher than that in SAP group (38.39 ± 36.50ng / L) and control group (28.09 ± 21.34ng / L) (P <0.05). There was no significant difference in the concentration of BNP between the SAP group and the control group (P> 0.05). There was a significant difference between the AMI group and the UAP group (P <0.05). BNP ≤ 80ng / L group than the BNP> 80ng / L group had a higher incidence of new or recurrent AMI, heart failure or deterioration. Conclusion: BNP has an important clinical value in the short-term prognosis of ACS patients and can be used as an indicator of risk stratification.