摘要
目的探讨测定脑钠素(BNP)对诊断无ST段抬高的急性冠脉综合征(ACS)的临床意义。方法采用放射免疫吸附法测定无ST段抬高的ACS患者和对照组血浆BNP浓度。将58例无ST段抬高的急性冠脉综合征患者分为非Q波心肌梗死组(NQM I组,28例)和不稳定型心绞痛组(UA组,30例)。分别测定症状发作6小时内及24小时的BNP、肌酸激酶同功酶(CK-MB)和心肌肌钙蛋白I(cTnI),并与30例对照组比较。结果症状发作6小时内BNP含量NQM I组(59.50μg/L±17.4μg/L)和UA组(38.54μg/L±15.8μg/L)均显著高于对照组(9.82μg/L±1.54μg/L),P<0.01;CK-MB和cTnI均无显著改变。症状发作24小时,NQM I组BNP(160.40μg/L±21.50μg/L)、CK-MB(52.50 U/L±18.4 U/L)和cTnI(10.45μg/L±2.95μg/L)显著高于对照组(9.84μg/L±1.65μg/L、10 U/L±9.5 U/L和0.040μg/L±001μg/L),P<0.01。UA组CK-MB有75.4%的患者为正常值(≤25 U/L),cTnI有62.5%的患者为正常值(≤0.1μg/L),而BNP显著高于对照组(P<0.01)。结论血浆BNP水平升高与无ST段抬高ACS有关,血浆BNP含量的测定有助于对无ST段抬高的ACS的早期诊断,并可作为评价ACS的危险分层或预后指标。
Objective To evaluate the value of measuring brain natriuretic peptide （BNP） in acute coronary syndromes （ACS） without ST elevation. Methods The serum levels of BNP were determined by enzyme-linked immunoabsorbent assay. Five-eight patients suffered from acute coronary syndromes without ST elevation were divided into non Q wave myocardial infarction group （group NQMI,28 cases） and unstable angina group （group UA,30 cases）. BNP and creatine Kinase MB （CK-MB） and cardiac troponin I （cTnI） were examined and compared between 58 patients and 30 healthy controls within 6 hours and 24 hours after the onset of symptoms. Results Significantly abnormal concentrations of BNP were observed in group NQMI （59.50 ± 17.4μ g/L） （P 〈 0.01 ） and group UA （38.54 ± 15.8μg/L） （ P 〈 0.01 ） compared to the controls （9.82 ± 1.54 μg/L） within 6 hours after the onset of symptoms. Both the CK-MB and cTnI level were similar in all groups. BNP （ 160.40 ± 21. 50μg/L）, CK-MB （ 52.50± 18.4U/L） and cTnI（ 10.45 ± 2.95μ g/L） in patients with non Q wave infarction were obviously higher than those in the controls（9.84 ± 1.65μ g/L） ,（ 10±9.5U/L） and （0.040 ±001μg/L） at 24 hours after onset of symptoms （ P 〈 0.01 ）. BNP was also significantly increased in unstable angina （ P 〈 0.01 ）. CK-MB and cTnI in 75.4% and 62.5% of cases of unstable angina were normal at 24 hours. Conclusions BNP has a strong association with non-ST elevation ACS, it can be used as an early diagnostic parameter and prognosis evaluation factor for non ST-elevation ACS.
出处
《临床内科杂志》
CAS
2005年第12期821-823,共3页
Journal of Clinical Internal Medicine
关键词
急性冠脉综合征
脑钠素
肌酸激酶同功酶
心肌肌钙蛋白I
Acute coronary syndromes
Brain natfiuretic peptide
Creatine Kinase MB
Cardiac troponin I
