STEMI患者血浆BNP、同型半胱氨酸水平与心肌损伤标记物及冠脉病变程度的相关性

发布时间：2018-05-16 20:33

本文选题：心肌梗死 + ST段抬高型　；参考：《山东医药》2017年33期

【摘要】：目的探讨急性ST段抬高型心肌梗死(STEMI)患者血浆脑钠尿肽(BNP)、同型半胱氨酸(Hcy)水平与心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)浓度、冠脉病变程度以及心功能之间的相关性。方法选取急性STEMI患者176例,根据血浆BNP峰值水平检测结果将其分为A组(BNP100 pg/m L)71例、B组(100 pg/m L≤BNP500 pg/m L)63例及C组(BNP≥500 pg/m L)42例。检测三组血浆BNP、Hcy、cTnI、CK-MB水平、冠脉病变程度及心脏结构功能并进行对比分析。结果 A、B、C组血浆cTnI、CK-MB、BNP、Hcy均依次升高,左心室射血分数(LVEF)均依次降低,左室舒张末压力(LVEDP)依次升高,组间比较差异有统计学意义(P均0.05);三组Killip分级、病变血管种类、病变血管类型、病变冠脉积分、侧支循环形成及TIMI血流分级相比较有统计学意义(P均0.05)。Spearman相关性分析显示,血浆BNP水平与cTnI、CK-MB水平、病更冠脉积分以及LVEDP呈正相关(r依次为0.702、0.738、0.696、0.483,P均0.05),与LVEF呈负相关(r=-0.655,P0.05);血浆Hcy水平与cTnI、CK-MB水平、病变冠脉积分以及LVEDP呈正相关(r依次为0.681、0.716、0.613、0.545,P均0.05),与LVEF呈负相关(r=-0.626,P0.05)。Logistic回归分析显示,吸烟、高血压、糖尿病、血脂异常、LVEF降低以及血浆cTnI、BNP、Hcy水平升高是急性STEMI发生的独立危险因素。结论急性STEMI患者血浆BNP、Hcy水平升高,心肌损伤标记物水平亦升高,提示冠脉病变程度明显加重且心功能变差。
[Abstract]:Objective to investigate the relationship between plasma brain natriuretic peptide (BNPN), homocysteine (Hcy) levels and the concentration of cardiac troponin I ~ (cTnI), creatine kinase isoenzyme (CK-MBB), the severity of coronary artery lesion and cardiac function in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods 176 patients with acute STEMI were divided into group A (n = 71), group B (n = 71) and group C (n = 63), and group C (n = 42). The levels of CK-MB, coronary artery lesion, cardiac structure and function were measured and compared among the three groups. Results the plasma cTnI- CK-MBN Hcy increased, left ventricular ejection fraction (LVEF) decreased in turn, left ventricular end-diastolic pressure (LVE-DPV) increased in turn, and the differences between the three groups were statistically significant (P < 0.05). Compared with coronary artery score, collateral circulation formation and TIMI blood flow grade, the correlation analysis of 0.05).Spearman showed that the plasma BNP level and cTnI CK-MB level were significantly higher than those in the control group. The positive correlation r of coronary artery score and LVEDP was 0.702 / 0.7380.696n 0.483N, respectively, and negatively correlated with LVEF. The plasma Hcy level was negatively correlated with the CK-MB level of cTnInI, the positive correlation r of coronary artery score and LVEDP was 0.6810.7160.6130.545p 0.05a, and negatively correlated with LVEF. Logistic regression analysis showed that smoking was negative correlation. Hypertension, diabetes, dyslipidemia and elevated plasma cTnI BNPP Hcy are independent risk factors for the development of acute STEMI. Conclusion the level of plasma BNP-Hcy and myocardial injury markers in patients with acute STEMI are increased, which indicates that the severity of coronary artery lesion is aggravated and the cardiac function becomes worse.
【作者单位】：安徽医科大学附属省立医院;
【基金】：安徽省科技厅年度重点科研项目(12020503078)
【分类号】：R542.22

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