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Objective:To investigate the correlation between serum N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and lipoprotein phospholipase A2 (Lp-PLA2) levels and the severity of coronary artery lesions in patients with acute coronary syndrome (ACS) complicated with type 2 diabetes mellitus (T2DM) .Methods:A total of 68 patients with ACS and T2DM who were admitted to our hospital from Jun. 2018 to Oct. 2020 were selected as the experimental group, and the control group was 52 patients with simple ACS. The serum NT-pro-BNP and Lp-PLA2 levels of the two groups of patients were detected, and the correlation between the serum NT-pro-BNP and Lp-PLA2 levels and the degree of coronary artery disease in patients with ACS complicated with T2DM was analyzed to screen for ACS complicated with T2DM. Influencing factors of moderate to severe coronary artery disease in diabetic patients were selected.Results:The serum levels of NT-pro-BNP[ (349.18±45.98 vs 235.68±26.37) ] ng/L and Lp-PLA2 [ (421.84±55.84 vs 318.62±36.69) ] ng/mL in the experimental group were higher than those in the control group ( P<0.05) . The levels of serum NT-pro-BNP [ (374.35±39.42 vs 320.88±35.41) ] ng/L and Lp-PLA2 [ (452.67±48.32 vs 387.16±40.45) ]ng/mL in the moderate-severe group were higher than those in the mild group ( P<0.05) . Serum NT-pro-BNP and Lp-PLA2 levels were positively correlated with the severity of coronary artery lesions in patients with ACS and T2DM ( r=-0.585, P=0.000; r=-0.595, P=0.000) . Serum NT-pro-BNP and Lp-PLA2 were risk factors for moderate to severe coronary artery disease in patients with ACS complicated with T2DM ( P<0.05) . Conclusion:Serum levels of NT-pro-BNP and Lp-PLA2 in patients with ACS complicated with type 2 diabetes mellitus are related to the degree of coronary artery disease.
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Objective To investigate the clinical value of heart-type fatty acid-binding protein ( H-FABP) and N terminal probrain natriuretic peptide (NT-proBNP) in sepsis patients with myocardium injury. Methods 118 sepsis patients were included as survivor group (68 cases) and death group (50 cases) according to their prognosis outcome. 50 healthy people were selected as control group. Creatase, H-FABP, NT-proBNP, APACHEⅡscore and 28 day morbidity of control group and sepsis patients were assessed at 1 h, 6 h after admission by physical examination . Results At 1 h after admission , APACHEⅡscore , H-FABP and NT-proBNP level in sepsis patients were significantly higher than control group (P < 0.05); APACHEⅡscore, H-FABP, NT-proBNP and cTnI level at 6 h after admission were higher than that at 1 h (P < 0.05); APACHEⅡscore, H-FABP and NT-proBNP level in death group were higher than survivor group at 1, 6 h after admission (P < 0.05), cTnI level at 6 h after admission was higher in death group (P < 0.05). Futhermore, H-FABP, NT-proBNP and cTnI at 6 h after admission were positively correlated with each other (both P < 0.05). At 6 h after admission , H-FABP showed a better predictive value of 28-day mortality than NT-proBNP and APACHEⅡscore (P < 0.05). Conclusion H-FABP and NT-proBNP may suggest important significance in early diagnosis and prognosis prediction of sepsis patients with myocardium injury.
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Objective To explore the role and relationship of N-terminal pro-brain natriuretic peptide (NT-proBNP) and matrix metalloproteinase-9 (MMP-9 ) in risk stratification and prognosis assessment of non-ST elevation acute coronary syndrome (NSTE-ACS).Methods We recruited 114 patients with NSTE-ACS and classified them into three groups according to the GRACE risk stratification:high-risk,intermediate-risk and low-risk groups.Another 5 8 patients were recruited as controls.Arterial blood was collected before angiography for the measurement of serum NT-proBNP and MMP-9 .Gensini score was used to evaluate the degree of coronary artery stenosis.All the patients were followed up for 6 months and MACE was observed and recorded.Results ① The levels of lg NT-proBNP and MMP-9 significantly differed between the groups (P<0.05).② ROC curve analysis showed that lg NT-proBNP could predict MACE of NSTE-ACS;area under the curve was 0.795,the cutoff value was 2 .0 6 9 ,corresponding to the NT-proBNP value of 1 1 6 .5 6 ng/L.MMP-9 could predict MACE of NSTE-ACS;area under the curve was 0 .6 9 6 ,the cutoff value was 3 2 .4 9 ng/ml;both of the abnormal indexes could predict MACE with the sensitivity of 80.41%,specificity of 82.19%,and Youden’s index of 0.63.③ Cox regression analysis showed that abnormal MMP-9 and NT-proBNP levels were independently related to the incidence of MACE by the value of OR as 3.751.Conclusion MMP-9 and NT-proBNP may be used as serological indicators in risk stratification of NSTE-ACS. The combined use of NT-proBNP and MMP-9 increases the power of predicting MACE.
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Objective To explore the significance of combined detection of D-Dimer,cardic troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-ProBNP)in acute coronary syndrome and the correlation between them.Methods 143 patients with acute coronary syndrome were selected as the observation group,and 40 CAG negative people as the control group.The difference between the two groups was compared and the correlation was analyzed.According to different diagnostics,patients in the observa-tion group were separated into 3 groups,unstable angina pectoris,non ST segment elevation myocardial infarction and ST segment elevation myocardial infarction.The correlation of D-Dimer,cTnI and NT-ProBNP with the severity of coronary artery disease was analyzed.Results The levels of D-Dimer,cTnI and NT-ProBNP in the observation group were higher than those in the control group,and the difference was statistically significant(P < 0.05 ).The severity of coronary artery disease had positive correlation with the test results (P <0.05).Conclusion The combined detection of D-Dimer,cTnI and NT-ProBNP could help to diagnose the acute coronary syndrome and the test result has a positive correlation with the severity of acute coronary syndrome.
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Objective To explore the changes and significance of plasma cardiotrophin-1 (CT-1) in children with heart failure.Methods Forty children with heart failure (NYHA Ⅱ,n =14;NYHA Ⅲ,n =16;NYHA Ⅳ,n =10)were chosen as observation group,and 20 healthy children without heart failure were taken as healthy control group.Plasma CT-1 was measured by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA).N terminal probrain natriuretic peptide(NT-pro BNP) concentration was tested by Pu Rui fluorescent dry quantitative analyzer.Left ventricular ejection fraction(LVEF) was evaluated by GE Vivid 7 doppler echocardiography and cardiac function assessed by modified ROSS score.Plasma CT-1 level,NT-pro BNP and LVEF were compared between the 2 groups.The correlation of plasma CT-1 level with NT-pro BNP and LVEF were analyzed in patients with different degrees of heart failure.Results Plasma levels of CT-1 and NT-pro BNP were significantly higher in children with heart failure than those in healthy control group (P ＜ 0.01),and with progression of heart failure,the levels of CT-1 and NT-pro B NP progressively increased in heart failure children.Plasma CT-1 level in different NYHA had statistical significance (F =55.5,P ＜0.01).Plasma CT-1 level was positive correlated with NT-pro BNP and modified ROSS score(r =0.787,0.848,all P ＜ 0.01),and negative associated with LVEF (r =-0.66,P ＜ 0.01),respectively,in heart failure children.Conclusions Plasma CT-1 level is significantly elevated in heart failure children.There are good correlation among CT-1,NT-pro BNP and LVEF.Plasma CT-1 is a reliable marker of reflecting the severity of heart failure,combined with NT-pro BNP detection helps to improve the diagnostic accuracy of heart failure in children.
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Objective To assess the risk factors of intradialytic-hypotension (IDH) among maintaining hemodialysis (MHD) patients and to explore the relation between NT-proBNP and IDH,thus to provide clinical evidence for the prevention and treatment of IDH.Methods A total of 202 MHD patients during March 2009 to May 2009 in our dialysis center were enrolled in the study.Intradialytic blood pressure (BP) was measured during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mm Hg or in mean artery pressure (MAP) more than l0 mm Hg.Logistic regression analysis was used to assess the risk factors of IDH.ROC curve was used to evaluate the diagnostic efficacy of serum NT-proBNP.Results The incidence of IDH was 42.1％.One hundred and seventeen patients with no-IDH (＜1/10 hypotensive events per 3 months) were served as controls.Fifty-five patients with o-IDH (≥ 1/ 10 but ≤1/3 hypotensive events per 3 months) and 30 patients with f-IDH (＞1/3 hypotensive events per 3 months) were identified among 202 patients.Multivariate regression analysis showed that age,gender,ultrafiltration rate,serum NT-proBNP,serum albumin,aortic root dimension (AoRD) were associated with IDH among MHD patients.Serum NT-proBNP was positively correlated with IDH.The area under the ROC curve (AUC) of NT-proBNP was 0.76 (95％ CI 0.69 to 0.83,P＜0.01).The cut-off value of serum NT-proBNP for IDH was 1746.5 ng/L,with a sensitivity of 88.61％ and a specificity of 51.10％.Furthermore,the AUC of NT-proBNP for f-IDH was 0.65 (95％ CI 0.53 to 0.763,P＜0.01).The cut-off value of serum NT-proBNP for f-IDH was 8208.0 ng/L,with a sensitivity of 33.33％ and a specificity of 91.30％.Conclusions Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia,shorter AoRD are independent risk factors of IDH among MHD patients.Serum NT-proBNP can be used as a predictor of IDH.