【摘 要】
：
目的 探讨血清胱抑素C (cystatin C,Cys C)和氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)对冠状动脉病变程度的诊断价值.方法 将224例患者根据
【机 构】
：
西安交通大学医学院第二附属医院心内科
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目的 探讨血清胱抑素C (cystatin C,Cys C)和氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)对冠状动脉病变程度的诊断价值.方法 将224例患者根据冠状动脉造影结果分为对照组(冠状动脉狭窄程度＜50％)及冠状动脉狭窄单支组、双支组和多支组(冠状动脉狭窄程度均≥50％).另根据冠状动脉粥样硬化性心脏病(冠心病)不同严重程度将患者分为对照组、稳定型心绞痛(stable angina,SAP)组、不稳定型心绞痛(unstable angina pectoris,UAP)组和急性心肌梗死(acute myocardial infarction,AMI)组.分别比较不同分组条件下各组血清Cys C和NT-proBNP浓度的差异.结果 血清Cys C和NT-proBNP浓度随着冠状动脉狭窄支数增加而升高,差异有统计学意义(P＜0.05).同时,二者浓度还与冠心病的临床类型有关,AMI组、UAP组和SAP组显著高于对照组,差异有统计学意义(P＜0.05);AMI组高于UAP和SAP组,差异有统计学意义(P＜0.05);UAP组高于SAP组,差异有统计学意义(P＜0.05).血清NT-proBNP诊断冠状动脉狭窄受试者工作特征曲线下面积0.859,最佳截断值94.01 ng/L,灵敏度71.9％,特异度92.0％.血清Cys C诊断冠状动脉狭窄受试者工作特征曲线下面积0.832,最佳截断值0.94 mg/L,灵敏度69.8％,特异度80.0％.两指标系列诊断试验可提高特异度,平行诊断试验可提高灵敏度.结论 血清Cys C和NT-proBNP对冠状动脉病变程度具有较好的诊断效能.
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