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目的：本研究旨在探讨质子泵抑制剂（PPI）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LN CgA 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LN NT-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。

英文摘要:

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.

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