摘要
目的探讨血浆B型钠尿肽(BNP)与老年急性冠状动脉综合征(ACS)行PCI患者临床预后的关系。方法选择符合ACS入选标准的住院患者244例,根据BNP水平分为≤80 ng/IL组78例,>80 ng/L组166例,测定症状发作24 h内BNP及随访住院期间、出院后6个月内主要不良心脏事件(MACE)发生情况。结果 131例患者发生MACE,35例死亡(14.8%)。BNP>80 ng/L组161例患者发生MACE 148例次,BNP≤80 ng/L组75例患者发生MACE 21例次(28.0%vs 91.9%,P<0.05)。冠状动脉多支病变、节段性室壁运动异常及LVEF<50%患者的BNP水平明显高于单支病变、节段性室壁运动正常及LVEF≥50%患者(P<0.05,P<0.01)。BNP水平与年龄呈正相关(r=0.037,P<0.01),与LVEF呈负相关(r=-0.181,P<0.01)。多因素logistic逐步回归分析显示,BNP(OR=4.284,P<0.01)和年龄(OR=1.917,P<0.05)为老年ACS患者PCI术后病死率的预测因素。结论 BNP能较好地独立预测老年ACS患者PCI术后的近期预后。
Objective To investigate the relation between B-type natriuretic peptide （BNP） and clinical prognosis of elderly patients with acute coronary syndrome（ACS） undergoing PCI. Methods 244 hospitalized patients who met the ACS inclusion criteria were divided into two groups according to BNP level：BNP level 480 ng/L group of 78 cases and 〉80 ng/L group of 166 cases. BNP within 24 h after symptom onset was measured and major adverse cardiac events （MACE） during hospitalization as well as within 6 months after discharge were followed up. Results MACE occurred in 131 cases,including 35 deaths（14.8%） and 134 non-fatal MACE occurred in 96 cases（of which 71 occurred in 33 cases）. 161 cases with BNP〉80 ng/L had 148 MACE and 75 cases with BNP ≤80 ng/L had 21 MACE. BNP levels of patients with multivessel coronary artery disease,segmental wall motion abnormalities and LVEF〈50% were significantly higher than those of patients with single-vessel disease, normal sagmental wall motion and LVEF≥50% （P 〈 0.05,P 〈 0.01）. BNP level correlated positively with age （r = 0. 037,P 〈0.01） and correlated negatively with LVEF （r =-0.181 ,P 〈 0.01）. Logistic regression analysis showed that BNP （OR = 4. 284, P 〈 0.01） and age （OR = 1. 917, P 〈 0.05） were predictors of fatality for elderly patients with ACS after PCI. Conclusion BNP can be a good independent predictor for recent prognosis of elderly patients with ACS after PCI.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2011年第3期214-217,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
急性冠状动脉综合征
利钠肽
脑
心肌缺血
冠状血管造影术
预测
预后
acute coronary syndrome
natriuretic peptide, brain
myocardial ischemia
coronary angiography
foreeasting
prognosis
