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目的调查冠心病、高血压病患者血清中氨基末端脑钠素前体(NT-proBNP)、心肌酶谱、超敏CRP水平,探讨其临床意义。方法用日立7600全自动生化分析仪测定患者血清中心肌酶谱,在BN-Ⅱ特种蛋白分析仪上检测患者血清中超敏CRP,应用ANALYTICSE170光电免疫发光仪对血清NT-proBNP的含量进行测定。结果①两患者组血清中除AST(谷草转氨酶)水平无显著改变外(P>0.05),其它指标与对照组相比存在差异(P<0.01或P<0.05):两患者组NT-proBNP、LDH-L(乳酸脱氢酶)、超敏CRP水平均显著升高(P<0.01),CK-MB(肌酸肌酶同功酶)水平升高(均P<0.05);冠心病患者血清中CK(肌酸肌酶)、HBDH(α-羟丁酸)水平明显升高(P<0.01),高血压组血清中CK、HBDH水平有所上升(P<0.05)。②两患者组相比AST、CK-MB无显著性差异(P>0.05),冠心病组NT-proBNP、超敏CRP、LDH-L、CK、HBDH水平高于高血压病组(P<0.05)。结论两患者组心肌酶谱的大部分指标均在参考范围内,以心肌酶谱水平反映心肌损伤存在相当的局限性,血清中NT-proBNP、超敏CRP的联合检测可作为心肌酶谱检测的有力补充,可能对心肌损伤的分析判断更有意义。
Objective To investigate the serum levels of N-terminal pro brain natriuretic peptide (NT-proBNP), myocardial enzymes and hypersensitive CRP in patients with coronary heart disease and hypertension and to investigate its clinical significance. Methods Serum myocardial enzymes were measured by Hitachi 7600 automatic biochemical analyzer. Serum levels of serum NT-proBNP were measured by BN-Ⅱ specific protein analyzer. The serum levels of NT-proBNP were detected by ANALYTICSE170 immunoelectrophoresis analyzer. Results ① There was no significant difference in serum AST (aspartate aminotransferase) between the two groups (P> 0.05), but there were significant differences between the two groups (P <0.01 or P <0.05). The NT-proBNP, LDH-L (LDH-L), hypersensitive CRP levels were significantly increased (P <0.01), CK-MB (creatine kinase isoenzyme) levels were increased CK (creatine kinase) and HBDH (a-hydroxybutyrate) were significantly increased (P <0.01). The serum levels of CK and HBDH in hypertension group were increased (P <0.05). ② The levels of NT-proBNP, CRP, LDH-L, CK and HBDH in CHD patients were significantly higher than those in hypertension patients (P <0.05) ). Conclusion Most of the myocardial enzymes in the two groups are within the reference range. There are some limitations in the detection of myocardial damage by the levels of myocardial enzymes. The combined detection of serum NT-proBNP and hypersensitive CRP can be used as the myocardial enzyme spectrum. Powerfully added, may be more meaningful to the analysis of myocardial injury.