| Background and purposeIn recent years, with the improvement of living standards, the spectrum of disease has undergone significant changes. Cardiovascular disease especially the acute coronary syndrom becomes the major killer of health. Acute coronary syndrom has been payed more attention because of its acute onset, rapid change and high mortality and becomes one of the research hotspot in the field of cardiovascular. At present, although ACS patients have got anticoagulant, intervention and thrombolytic therapy , its clinical mortality rate is still about 4% , so , how to diagnose early ,choose the optimal therapeutic schedule and assess prognosis correctly becomes extremely important. B-type natriuretic peptide is a kind of peptide hormone containing 32 amino acid. Its clinical value in diagnosis of heart failure , determination of the prognosic and severity of the patients'condition and the therapy of heart failure has been confirmed. Furthermore, recent studies have shown that BNP in patients with acute coronary syndrome has increased significantly and the application value of BNP in acute coronary syndrome is focused on more and more. This study discussed ACS patients of different clinical types and non-coronary heart disease patients contrastively with method of case-control sduty in order to investigate the change of plasma BNP concentration of ACS patients in different clinical types and the correlation betweeen it and myocardial necrosis markers. It studied the clinical meaning of the change and the correlation in ACS patients so as to provide certain help on early screening, risk stratification and treatment of high-risk populations.Methods: We studied a cohort of 144 patients with acute coronary syndrome and divided them into three groups according to diagnostic criteria : ST elevated myocardial infarction , Non-ST segment elevated myocardial infarction and unstable angina pectoris groups . And we selected 36 patients with non-coronary heart disease as the normal control group as random . We determined the BNP levels in plasma and troponin I quantities of ST elevated myocardial infarction and Non-ST segment elevated myocardial infarction groups with immuno- fluorescence . We indicated measurement data with mean±standard deviation and the entirety with single factor analysis of variance while bivariate correlativity factor analysis of BNP and cTnI was performed.Results:Plasma levels of BNP were 26.20±19.61pg/ml(n=36), 694.89±171.56pg/ml (n=39) , 436.46±137.04pg/ml(n=32) , 361.09±74.15pg/ml (n=73) in the normal control , ST elevated myocardial infarction , non-ST segment elevated myocardial infarction and unstable angina pectoris groups respectively . We indicated the entirety with single factor analysis of variance and the results of BNP of each group were different significantly (F=261.41,P<0.01). compared pairwise with SNK method , there are differences between each two groups(P<0.05). The level of BNP was significantly higher in ST elevated myocardial infarction group than that in other three groups(P<0.05),the level of BNP was higher in non-ST segment elevated myocardial infarction group than that in unstable angina pectoris and normal control group (P<0.05) and the level of BNP was higher in unstable angina pectoris group than that in normal control group (P<0.05).Bivariate correlativity factor analysis of BNP and cTnI was performed and BNP was in direct proportion to cTnI in both ST elevated myocardial infarction group(r=0.886,P<0.01) and non-ST segment elevated myocardial infarction group(r=0.974,P<0.01).Conclusion: 1.Myocardial ischemia is the important factor to promote synthesis and release of the BNP.2. Plasma BNP levels of acute coronary syndrome patients of different types were significantly different.3. Determine of plasma BNP levels has important value in the early diagnosis of acute coronary syndrome .4. Plasma level of BNP may reflect degree of myocardial necrosis to a certian extent.
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