临床医学毕业论文冠心病心绞痛患者血清hs-crp和bnp检测的临床意义

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1、XX大学毕业论文冠心病心绞痛患者血清hs・CRP和BNP检测的临床意义姓名：2014年6月25日冠心病心绞痛患者血清hs-CRP和BNP检测的临床意义【摘要】目的探讨冠心病心绞痛患者血清高敏C■反应蛋白(hs-CRP)和脑型钠尿肽(BNP)的水平与冠状动脉病变的严重程度及心功能的关系。方法入选115例冠状动脉造影阳性心绞痛患者作为冠心病组，40例冠状动脉造影阴性的胸闷症状患者作为对照组。冠心病组根据心绞痛类型进一步分为稳定型心绞痛组(SA组，n=68)和不稳定型心绞痛组(UA组，n=47);根据冠状动脉造影结果分为单支病变组(n=35)、双支病变组(n=38)和三支病变组

2、5=42)，并对冠状动脉进行病变积分。按美国纽约心脏病协会(NYHA)心功能分级标准将心绞痛患者分为心功能I级(n=25)>II级(n=40)、III级(n=35)和IV级(n=15)。测定各组患者hs-CRP>BNP的水平和左心室射血分数(LVEF)。将BNP分别与冠状动脉病变的支数与积分、NYHA心功能级别、LVEF值进行相关性分析。结果冠心病组血清hs-CRP和BNP水平均显著高于对照组(P0.05),不稳定型心绞痛患者(UA组)hs-CRP和BNP水平明显高于稳定型心绞痛患者(SA组)(P0.05)；单支病变组hs-CRP和BNP水平较对照组显著升高(P0.05)

3、,双支与三支病变组hs-CRP和BNP水平较单支病变组及对照组显著升高(P0.05),三支病变组hs-CRP和BNP水平较双支病变组显著升高(P0.05)；BNP水平与冠状动脉病变的支数呈正相关(r=0・65,P0.05),与冠状动脉病变积分呈正相关(r=0.301,P0.05)；BNP与NYHA心功能级别呈止相关(r=0.78,P0.05),与LVEF呈负相关(r=-0.56,P0.05)o随着NYHA分级的增加，血清CRP和BNP水平明显升高(P0.05)o结论血清hs-CRP和BNP的水平可以作为评价冠心病心绞痛患者冠状动脉病变的严重程度、心绞痛危险分层和心功能分级

4、的辅助指标。【关键词】冠心病心绞痛高敏C■反应蛋白脑型钠尿肽心功能Abstract:ObjectiveToinvestigatetherelationshipbetweenthesemmlevelsofhigh-sensitivityC-reactiveprotein(hs-CRP)andbrainnatriureticpeptide(BNP)andthedegreeofillnessandheartfunctioninthecoronaryheartdisease(CHD)patientspositiveforanginapectoris-MethodsThesurve

5、ygroupconsistedof115anginapatientswhoseCHDdiagnosiswasconfirmedbypositiveCAGresults,with40patientsofnegativeCAGresultstakentoformthecontrolgroup.Intheanginapatientsurveygroup,therewere68casesofstableangina(SA)and47casesofunstableangina(UA);35patientswithsingle-arterylesion,38withtwo-arter

6、ylesionand42withthree-arterylesion.TheanginapatientswerealsodividedintogroupsaccordingtotheNYHAclassificationofheartfailure・Thescrumlevelsofhs-CRPandBNPandtheLVEFweremeasured;thedataobtainedwereanalyzedstatistically.ResultsTheserumlevelsofhs-CRPandBNPweresignificantlyhigherinthesurveygrou

7、pthanthoseinthecontrolgroup(P0.05).TheselevelsweresignificantlyhigherinUAgroupthaninSAgroup(P0.05);significantlyhigherintheCHDpatientswithsingle-arterylesionthaninthecontrol(P0.05);significantlyhigherinCHDpatientswithtwo-arteryorthree-arterylesionthaninthosewithsing