摘要
目的探讨静脉血B型钠尿肽(BNP)在非ST段抬高心肌梗死(NSTEMI)的早期诊断及预测预后的价值。方法选择急诊临床疑似NSTEMI急性冠状动脉综合征患者161例,经冠状动脉造影结合肌钙蛋白I(cTnI)≥0.15μg/L诊断非ST抬高型心肌梗死(NSTEMI)83例。161例患者中就诊时BNP≥100 ng/L的99例,并以BNP≥100 ng/L为阈值预测诊断NSTEMI。用冠状动脉造影结合cTnI≥0.15μg/L诊断NSTEMI为标准评估,BNP≥100 ng/L为阈值预测诊断NSTEMI的敏感性、特异性。83例NSTEMI患者进行30 d主要不良心血管事件临床随访。结果以BNP≥100 ng/L为阈值进行早期诊断与冠状动脉造影结合cTnI诊断NSTEMI相比较,敏感性81.9%,特异性60.7%,ROC曲线下面积为0.808(95%CI:0.739～0.877,P<0.05)。心血管事件患者BNP水平明显高于非心血管事件患者(P<0.05)。BNP水平判断是否发生心血管事件的ROC曲线下面积为0.866(95%CI:0.790～0.942,P<0.05)。结论在NSTEMI中BNP可以辅助诊断,并能独立预测心血管事件的发生。
Objective To study the value of B-type natriuretic peptide（BNP） for early diagnosis and prediction of non-ST segment elevation myocardial infarction（NSTEMI） patients. Methods Of the 161 emergency patients with acute coronary syndrome who were suspected of NSTEMI,83 were diagnosed as NSTEMI by coronary angiography with cardiac troponin I（cTnI）≥0.15 μg/L. The BNP was ≥100 ng/L in 99 patients and NSTEMI was diagnosed when the BNP was ≥100 ng/L. Coronary angiography with cTnI≥0.15 μg/L was used as a standard to assess the sensitivity and specificity of BNP≥100 ng/L in diagnosis of NSTEMI. The 83 patients were followed up for 30 days to observe the major adverse cardiovascular events. Results The sensitivity and speci- ficity of BNP≥100 ng/L for the early diagnosis of NSTEMI were 81.9% and 60.7% respective- ly,and the area under ROC curve was 0. 808（95%CI：0. 739-0. 877,P〈0.05）. The BNP level was significantly higher in patients with cardiovascular events than in those without cardiovascu- lar events（P〈0.05）. The area under ROC curve was 0. 866（95%CI：0. 790-0. 942,P〈0.05） when the BNP level was used to judge the occurrence of cardiovascular events. Conclusion BNP contributes to the early diagnosis of NSTEMI and can,thus,independently predict the occurrence of cardiovascular events.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第4期380-382,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
心肌梗死
利钠肽
脑
急性冠状动脉综合征
肌钙蛋白
冠状血管造影术
早期诊断
预后
myocardial infarction
natriuretic peptide, brain
acute coronary syndrome
troponin
coronary angiography
early diagnosis
prognosis
