血漿同型半胱氨酸、B型鈉尿肽聯(lián)合檢測在冠心病中的應(yīng)用評價(jià)
發(fā)布時(shí)間：2018-07-20 12:36
【摘要】：目的:探討血漿同型半胱氨酸和B型鈉尿肽聯(lián)合檢測在冠心病(CHD)中的應(yīng)用評價(jià)。方法:選擇2011-09至2012-09期間在唐山工人醫(yī)院心內(nèi)科住院的冠心病患者475例(入院的患者均符合冠心病臨床診斷且冠脈造影結(jié)果陽性),按累及血管支數(shù)分為單支病變組(224例)、雙支病變組(160例)、三支病變組(91例),左主干病變列為雙支病變。所有患者依照臨床分型分為:不穩(wěn)定型心絞痛組(171例),其中男98例,女73例,年齡36歲~72歲(51.0歲±8.7歲);急性心肌梗死組(185例),其中男100例,女85例,年齡45歲~76歲(57.0歲±13.2歲);穩(wěn)定型心絞痛組(119例),其中男68例,女51例,年齡42歲~75歲(54.0歲±16.7歲)。同時(shí)選取無冠心病病史且冠脈造影陰性者138例作為對照組,男性71例,女性67例,年齡40~60歲,平均(52.36±5.52)歲。冠心病組與對照組均為居住于唐山地區(qū)的漢族人,無血緣關(guān)系,詳細(xì)詢問患者的吸煙史、高血壓病史、糖尿病病史、高膽固醇病史等相關(guān)冠心病危險(xiǎn)因素,排除了腦血管疾病、慢性腎功能不全、慢性肝功能不全、心力衰竭、肺部疾病、腫瘤或相關(guān)藥物等影響Hcy及BNP的升高的相關(guān)因素。研究個(gè)體之間不重復(fù),入選患者冠狀動(dòng)脈造影及采血前獲取知情同意�；颊吖诿}造影前測定各組血漿同型半胱氨酸(Hcy)及B型鈉尿肽(BNP)濃度。冠脈造影后采用Gensini評分系統(tǒng)評定冠狀動(dòng)脈狹窄程度。比較冠心病組與對照組及冠心病各組間的Hcy及BNP水平,并將BNP水平與各組Gensini評分及冠脈病變程度作相關(guān)性分析。冠心病組患者隨訪1年,記錄主要心血管不良事件,同時(shí)分析冠心病不同組別Hcy、BNP與發(fā)生心血管不良事件的關(guān)系。采用SPSS13.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,相關(guān)性用相關(guān)分析,計(jì)數(shù)資料比較用χ2檢驗(yàn),P0.05具有統(tǒng)計(jì)學(xué)意義。結(jié)果:AMI、UAP組、SAP組及對照組血漿Hcy分別為27.38±13.67mmol/L、19.34±13.19mmol/L、13.59±3.84mmol/L、8.82±2.23mmol/L;以上四組血漿BNP分別為152.59±57.78pg/ml、89.34±26.67pg/ml、55.40±20.21pg/ml、41.68±8.16pg/ml,冠心病組水平均明顯高于正常對照組,且冠心病組組間比較顯示急性心肌梗死組不穩(wěn)定型心絞痛組穩(wěn)定性心絞痛組(P0.05),差異有統(tǒng)計(jì)學(xué)意義。冠心病組中(Hcy及BNP水平)三支病變組二支病變組一支病變組(P0.05),隨著冠狀動(dòng)脈病變類型嚴(yán)重程度的增加,Hcy、BNP明顯增高。血漿BNP水平與冠狀動(dòng)脈病變支數(shù)、評分之間呈正相關(guān),相關(guān)系數(shù)分別為r1=0.251、r2=0.554。對冠心病組患者隨訪1年發(fā)現(xiàn),475例患者中發(fā)生心血管事件的有32例(6.7%),發(fā)生者Hcy及BNP水平高于未發(fā)生心血管事件的患者。結(jié)論:冠心病患者血漿Hcy、BNP水平高于正常人群,且Hcy、BNP水平隨冠狀動(dòng)脈受累數(shù)目的增多而升高,它作為篩查心血管疾病良好的生化指標(biāo),對冠心病的早期診斷和治療具有重要意義。
[Abstract]:Objective: to evaluate the application of plasma homocysteine and B type natriuretic peptide in coronary heart disease (CHD). Methods: 475 patients with coronary heart disease (CHD) hospitalized in Department of Cardiology, Tangshan Workers' Hospital from September 2011 to September 2012 were selected (all the patients were in accordance with the clinical diagnosis of coronary heart disease and the results of coronary angiography were positive). The patients were divided into single vessel lesion group according to the number of branches involved. (224 cases), double vessel lesion group (160 cases), three vessel lesion group (91 cases), left main artery disease was classified as double vessel disease. According to the clinical classification, all the patients were divided into unstable angina pectoris group (171 cases), male 98 cases, female 73 cases, age 36 years 72 years (51.0 鹵8.7 years), acute myocardial infarction group (185 cases), male 100 cases, female 85 cases, acute myocardial infarction group (185 cases). The patients were 45 years old and 76 years old (57.0 鹵13.2 years old) and stable angina pectoris group (119 cases), including 68 males and 51 females, aged 42 years and 75 years (54.0 鹵16.7 years). 138 patients with no history of coronary heart disease and negative coronary angiography were selected as control group. There were 71 males and 67 females with an average age of (52.36 鹵5.52) years. The coronary heart disease group and the control group were both Han people living in Tangshan area. There was no blood relationship. The risk factors of coronary heart disease such as smoking history, hypertension history, diabetes history, hypercholesterolemia history and so on were asked in detail, and cerebrovascular diseases were excluded. Chronic renal insufficiency, chronic liver insufficiency, heart failure, lung disease, tumor or related drugs and other related factors affecting the increase of Hcy and BNP. There was no duplication between individuals, and informed consent was obtained before coronary angiography and blood sampling. Plasma homocysteine (Hcy) and type B natriuretic peptide (BNP) were measured before coronary angiography. The degree of coronary artery stenosis was evaluated by Gensini scoring system after coronary angiography. The levels of Hcy and BNP were compared between coronary heart disease group and control group, and the correlation between BNP level and Gensini score and severity of coronary artery disease was analyzed. The patients in coronary heart disease group were followed up for one year to record the main adverse cardiovascular events and to analyze the relationship between Hcyn BNP and cardiovascular adverse events in different groups of coronary heart disease. SPSS 13.0 statistical software was used for statistical analysis, correlation analysis was used for correlation analysis, and 蠂 2 test was used to compare the count data (P0.05) with statistical significance. Results the plasma Hcy levels in SAP group and control group were 27.38 鹵13.67 mmol / L 19.34 鹵13.19 mmol / L and 8.82 鹵2.23 mmol / L, respectively, and those in the above four groups were 152.59 鹵57.78 mg / ml, 89.34 鹵26.67 PG / ml, 55.40 鹵20.21 mg / L and 41.68 鹵8.16 mmol / L, respectively. The levels of plasma Hcy in CHD group were significantly higher than those in normal control group. And coronary heart disease group comparison showed that acute myocardial infarction group unstable angina pectoris group (P0.05), the difference was statistically significant. In the coronary heart disease group (Hcy and BNP levels), the level of Hcy and BNP in the three-vessel lesion group was significantly increased with the increase of the severity of coronary artery disease type (P0.05). The plasma BNP level was positively correlated with the number and score of coronary artery lesion, and the correlation coefficient was 0.251g / r _ 2 and 0.554respectively. 32 (6.7%) of 475 patients in coronary heart disease group were followed up for one year. The levels of Hcy and BNP were higher in patients with coronary heart disease than those without cardiovascular events. Conclusion: the plasma level of Hcyn BNP in patients with coronary heart disease is higher than that in normal subjects, and the level of Hcyn BNP increases with the increase of the number of coronary artery involvement. As a good biochemical index for screening cardiovascular disease, it is of great significance for the early diagnosis and treatment of coronary heart disease.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.4
本文編號：2133531
[Abstract]:Objective: to evaluate the application of plasma homocysteine and B type natriuretic peptide in coronary heart disease (CHD). Methods: 475 patients with coronary heart disease (CHD) hospitalized in Department of Cardiology, Tangshan Workers' Hospital from September 2011 to September 2012 were selected (all the patients were in accordance with the clinical diagnosis of coronary heart disease and the results of coronary angiography were positive). The patients were divided into single vessel lesion group according to the number of branches involved. (224 cases), double vessel lesion group (160 cases), three vessel lesion group (91 cases), left main artery disease was classified as double vessel disease. According to the clinical classification, all the patients were divided into unstable angina pectoris group (171 cases), male 98 cases, female 73 cases, age 36 years 72 years (51.0 鹵8.7 years), acute myocardial infarction group (185 cases), male 100 cases, female 85 cases, acute myocardial infarction group (185 cases). The patients were 45 years old and 76 years old (57.0 鹵13.2 years old) and stable angina pectoris group (119 cases), including 68 males and 51 females, aged 42 years and 75 years (54.0 鹵16.7 years). 138 patients with no history of coronary heart disease and negative coronary angiography were selected as control group. There were 71 males and 67 females with an average age of (52.36 鹵5.52) years. The coronary heart disease group and the control group were both Han people living in Tangshan area. There was no blood relationship. The risk factors of coronary heart disease such as smoking history, hypertension history, diabetes history, hypercholesterolemia history and so on were asked in detail, and cerebrovascular diseases were excluded. Chronic renal insufficiency, chronic liver insufficiency, heart failure, lung disease, tumor or related drugs and other related factors affecting the increase of Hcy and BNP. There was no duplication between individuals, and informed consent was obtained before coronary angiography and blood sampling. Plasma homocysteine (Hcy) and type B natriuretic peptide (BNP) were measured before coronary angiography. The degree of coronary artery stenosis was evaluated by Gensini scoring system after coronary angiography. The levels of Hcy and BNP were compared between coronary heart disease group and control group, and the correlation between BNP level and Gensini score and severity of coronary artery disease was analyzed. The patients in coronary heart disease group were followed up for one year to record the main adverse cardiovascular events and to analyze the relationship between Hcyn BNP and cardiovascular adverse events in different groups of coronary heart disease. SPSS 13.0 statistical software was used for statistical analysis, correlation analysis was used for correlation analysis, and 蠂 2 test was used to compare the count data (P0.05) with statistical significance. Results the plasma Hcy levels in SAP group and control group were 27.38 鹵13.67 mmol / L 19.34 鹵13.19 mmol / L and 8.82 鹵2.23 mmol / L, respectively, and those in the above four groups were 152.59 鹵57.78 mg / ml, 89.34 鹵26.67 PG / ml, 55.40 鹵20.21 mg / L and 41.68 鹵8.16 mmol / L, respectively. The levels of plasma Hcy in CHD group were significantly higher than those in normal control group. And coronary heart disease group comparison showed that acute myocardial infarction group unstable angina pectoris group (P0.05), the difference was statistically significant. In the coronary heart disease group (Hcy and BNP levels), the level of Hcy and BNP in the three-vessel lesion group was significantly increased with the increase of the severity of coronary artery disease type (P0.05). The plasma BNP level was positively correlated with the number and score of coronary artery lesion, and the correlation coefficient was 0.251g / r _ 2 and 0.554respectively. 32 (6.7%) of 475 patients in coronary heart disease group were followed up for one year. The levels of Hcy and BNP were higher in patients with coronary heart disease than those without cardiovascular events. Conclusion: the plasma level of Hcyn BNP in patients with coronary heart disease is higher than that in normal subjects, and the level of Hcyn BNP increases with the increase of the number of coronary artery involvement. As a good biochemical index for screening cardiovascular disease, it is of great significance for the early diagnosis and treatment of coronary heart disease.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.4
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