The Level Of Serum BNP In The Patients With Early Acute Coronary Syndrom And Its Clinical Significance

PrefaceAcute aeteria coronaria syndrome ( ACS) is a series of acute myocardial ischemic diseases, including unstable angina pectoris (UA), non - ST section supra - lift myocardial infarct ( NSTEMI) and ST section supra - lift myocardial infarct (STEMI) , with common pathological and physiological basis,but their clinic prognoses differ on great extent. During this process, excessive cardiac neural and humoral activation play an important role. BNP has an restraining effect on sympathetic nerve system by contradicting RAS. In this study, the relationship between the earlier serum BNP level of ACS patients and clinical types, left cardiac function and the extent of pathological changes of coronary artery will be investigated in this paper.Materials and MethodsThe cases selectionSubjects were the patients of Cardiac Internal Medicine Department in the Shenzhou hospital, who were consistent with the relating standard about unstable angina pectoris of American Consortium of Cardiology( ACC/AHA) in 2000.Exclusive standard: aged more than 80 years old or less than 18 years old, symptomatic cardiac failure; renal disfunction; valvular heart disease; cardiomyopathy ; supraventricular or ventricular tachycaidia, arteria pulmonalis embolism.Normal control group were consisted with 13 heathy people who were bolting from Out - patient medical examination, excluding chronical cardiac, cere-bral and renal diseases. And there were no obvious differences in sex, age, blood pressure and heart rate between patients (P >0.05 ). 1. Methods1) the collection of samples(1) all patients selected were drawed cubital vein blood after 30 minutes in emergency room or hospital admission. Collect the blood serum centrifuged and detect Ctnl. The surplus serum was stored with the temperature - 70℃, preparing for measuring BNP.(2) left ventricle ejection fraction of all patients selected were measured after drawing(3) acute myocardial infarct (including STEMI and NSTEMI ) patients were progressed corona arteries opacification after a week in hospital.(4) normal control are drawed the ulnar vein blood empty stomach under resting state at 8 am. Detect CtnI of the serum centrifuged, and the surplus serum was stored with the temperature - 70 ℃ , preparing for measuring BNP.2) detection indexes(1) the assaying of the blood serum BNP used ELISA kit provided from Dalian Fanbang Chemical Engineering development Ltd,Co.(2) left ventricle ejection fraction determination: applied Toshiba 8000 color Doppler diasonography.(3) Aeteria coronaria affection determination: applied Judkins aeteria coro-naria radiography, and aeteria coronaria angusty more than 50% had sense referring to Bogaty method, then counting the number of main angiostegnosis below the epicardium .3 . statistical treatmentMeasurement data was expressed by means of x ± s, SPSS11.5 software was used for comparison, single factor ANOVA or t - test to test interclass difference, p <0.05 was significant.Result1 general data comparison between subjects in different groupACS group compares with control group having higher blood pressure and heart rate but without statistical difference (p >0.05)2UA group' s LVEF level were all above 50%. NSTEMI - 1,STEM - 1 group according to VEF above 50% compares with UA group' s blood serum BNP content having significant difference p <0.05; Comparison between NSTE-MI2 and STEMI2 blood serum BNP content had no significant difference (p>0. 05).3STEMI - 1 group between and STEMI - 2 compared blood serum BNP content had significant difference ( p < 0.001).4 AMI group according to the number of aeteria coronaria affection , com-parision between single change and multitude changes blood serum BNP content was significant different (p <0.01).DiscussionACS is a group of myocardial ischemia disease. According to severe degree classification, from UA to AMI the common pathological and physiological characteristics is alternated aeteria coronaria spasm, athero - plaque shedding, platelet aggregation and thrombogenesis, Casco detected BNP existence and distribution condition in the coronary atherosclerosis, and discovered different an-giosclerosis process has different appearance. Earlier period fatty streak stage appearances low - level BNP; intermediate stage appearances more BNP; but at the atherosclerotic progression stage abound with BNP. It has the same result as multitude change contains more blood serum BNP in AMI group。 Harumoto et. al found the blood plasm BNP stepped up in coronary artery disease in sport test, and the synchronization heart radioisotope scanning confirmed there is a direct ratio between the elevated amplitude of the blood plasm BNP and the extent of heart muscle ischemia. Our results discover the BNP concentration in serum show the significance of the difference among the UA , NSTEM1, and STEMI1 group. But there is significance of the difference between the STEMI and NSTE-MI1 group, indicating BNP is the high risk factor whether the ACS high - risk group has st - section alteration or not. And the level of BNP and the AMI inarct...