山东医药2017，Vol.57Issue(33)：12-15,4.DOI:10.3969/j.issn.1002-266X.2017.33.004
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
Correlation of plasma levels of B-type natriuretic peptide and homocysteine with markers of myocardial injury and degree of coronary lesions in patients with STEMI
摘要
Abstract
Objective To investigate the correlations of B-type natriuretic peptide (BNP) and homocysteine (Hcy) levels with cardiac troponin I (cTnI), creatine kinase MB (CK-MB) concentration, degree of coronary lesions, and cardiac function in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods Totally 176 patients with acute STEMI were selected.According to the results of plasma BNP peak detection, they were divided into the group A (BNP<100 pg/mL, 71 cases), group B (100 pg/mL≤BNP<500 pg/mL, 63 cases), and group C (BNP≥500 pg/mL, 42 cases).We recorded and compared the plasma levels of BNP, Hcy, and cTnI, CK-MB concentration, degree of coronary lesions, and cardiac function between the three groups.Results The plasma levels of cTnI, CK-MB, BNP, and Hcy in the groups A, B, C gradually increased, left ventricular ejection fraction (LVEF) gradually decreased, left ventricular end-diastolic pressure (LVEDP) gradually increased, and the difference between every two groups were significant (all P<0.05).The differences in the Killip grade, vascular lesions, lesion type, lesion type integral, coronary collateral circulation, and TIMI flow grade between the three groups were statistically significant (all P<0.05).Spearman correlation analysis showed that the plasma BNP level was positively correlated with cTnI, CK-MB, coronary score, and LVEDP (r=0.702, 0.738, 0.696, 0.483, respectively;all P<0.05), and was negatively correlated with LVEF (r=-0.655, P<0.05).The plasma Hcy level was positively correlated with cTnI,CK-MB, coronary score, and LVEDP (r=0.681, 0.716, 0.613, 0.545, respectively;all P<0.05), and was negatively correlated with LVEF (r=-0.626, P<0.05).Logistic regression analysis showed that smoking, hypertension, diabetes mellitus, dyslipidemia and decreased LVEF, and increased plasma levels of cTnI, BNP, and Hcy were independent risk factors for acute STEMI.Conclusion With the increasing plasma BNP and Hcy levels in patients with acute STEMI, the markers of myocardial injury increase significantly, which indicates that the degree of coronary lesions is significantly aggravated and the cardiac function is worse.关键词
心肌梗死,ST段抬高型,急性/利钠肽,脑/同型半胱氨酸/心肌标志物/冠脉病变积分Key words
myocardial infarction/ST-segment elevation/acute/B-type natriuretic peptide/homocysteine/myocardial markers/coronary lesion score分类
医药卫生引用本文复制引用
马芳涛,张小玲..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[J].山东医药,2017,57(33):12-15,4.基金项目
安徽省科技厅年度重点科研项目(12020503078). （12020503078）
