质子泵抑制剂对冠心病患者嗜铬粒蛋白A影响的临床意义

目的：本研究旨在探讨质子泵抑制剂（vii）对心内科拟诊断为冠心病患者的嗜铬粒蛋白A（CgA）水平影响的临床意义。方法：113名拟诊冠心病的住院患者，分为PPI组（药物治疗中加入PPI，共62例）和非PPI组（药物治疗中无PPI，共51例），收集其外周血清，用ELISA法检测样本血清中CgA水平，同时应用化学发光法检测样本血清中NT—proBNP水平。比较PPI组和非PPI组CgA、NT．proBNP水平的差异。结果：因为CgA、NT．proBNP均为非正态分布资料，两者均通过对数转换为正态分布资料；PPI组的LNCgA的均数显著高于非PPI组（4．62±0．97和3．91±0．89，P=0．000）。而两组LNNT-proBNP的均数无显著差异（5．41±1．46和5．59±2．00，P=0．580）。结论：在心功能等临床特征具有可比性的情况下，是否使用PPI对CgA水平的影响很大；而对BNP无明显影响。评价CgA在心功能分级或冠心病预后等方面的应用，不能忽略PPI联用对CgA数值的影响。

Effects of Proton-pump Inhibitor on Serum Chromogranin A Level in Patients with Coronary Heart Disease

Objective： To study when treated with proton-pump inhibitor, where there is effect on the circulation levels of chromogranin A （CgA） in patients with the coronary heart disease. Methods： 113 patients were divided into PPI group （who were treated combined with PPI） and non-PPI group （without PPI treatment）, and had their circulating CgA levels measured by the commercially available ELISA assay and NT-proBNP by immunofluorcscent assays on day before coronary artery angiography. The difference in the levels of CgA, NT-pro BNP between PPI group and group non-PPI group were analysised. Results： Logarithmic conversion was performed for non-positive asymmetric distribution of CgA and NT-pro BNP levels. The mean of LN CgA in PPI group is much higher than that in non-PPI group （4.62±0.97 and 3.91±0.89,P=0.000）, the difference is significant. While for LN NT-pro BNP, there is no difference between the two groups. （5.41± 1.46 and 5.59± 2.00,P=0.580）. Conclusions： In the situation of when the heart function and other clinical traits have comparisons, whether use PPI or not may have some effect on the circulation levels of CgA, but not for BNP, which may have no effection. When evaluating the effort of CgA on the classify to the heart function and the prognosis of CHD, it is not appropriate to ignore the effect of CgA caused by using PPI.