摘要
目的探讨急性冠脉综合征(acute coronary syndrome,ACS)患者N端B型脑钠肽前体(N-terminal pro-B-type natriureticpeptide,NT-proBNP)与冠状动脉病变严重程度及心功能的相关性。方法入选住院的急性心肌梗死(acute myocardial in-farction,AMI)患者60例,不稳定型心绞痛(unstable angina,UA)患者62例。分别于患者入院时、冠脉介入治疗(PCI)术后即刻、术后1月及3月通过电化学发光法测定血NT-proBNP水平;分析各组不同时期NT-proBNP水平与左室射血分数(ejectionfraction,EF)、左心室舒张末期内径(end-diastolic dimension,EDD)及左心室收缩末期内径(end-systolic dimension,ESD)相关性;并比较两组术后6月主要心脏不良事件(major adverse cardiac events,MACE)发生率。结果①AMI组不同时间点血NT-proBNP水平显著高于UA组,差异有统计学意义(P<0.05)。②术后即刻及术后1、3月AMI组患者NT-proBNP水平分别与住院期间及术后左室EF值负相关(P<0.01);UA组患者术后即刻及术后1月NT-proBNP水平分别与住院期间及与术后左室EF值负相关(P<0.01)。③AMI组术后即刻NT-proBNP>1 205 pg/ml组及UA组术后即刻NT-proBNP>265 pg/ml组术后6月MACE发生率明显增高。结论 ACS患者NT-proBNP水平与冠状动脉病变严重程度以及术后心功能相关,与远期MACE事件发生率相关,可作为ACS患者PCI术后心血管事件危险评估的预测指标。
Objective To explore the relationship between the plasma levels of N-terminal pro-B-type natriuretic peptide（NT-proBNP） and the severity of coronary artery,heart function in patients with acute coronary syndrome（ACS）.Methods In 60 patients with acute myocardial infarction（AMI） and 62 patients with unstable angina（UA）,the serum levels of NT-proBNP were measured by electrochemistry luminescent technique at the immediate postoperation,1 month and 3 months after percutaneous coronary intervention（PCI）.The relationships between the plasma levels of NT-proBNP and the ejection fraction（EF）,the end-diastolic dimension（EDD） and the end-systolic dimension（ESD） were analyzed.The rates of major adverse cardiac events（MACE） in different groups were compared 6 months after PCI.Results ①The level of NT-proBNP in patients with AMI was statistically higher than that in patients with UA（P0.05）.②The levels of NT-proBNP at the immediate postoperation,1 month and 3 months after PCI in patients with AMI were negatively correlated with EF（P0.01）.The levels of NT-proBNP at the immediate postoperation and 1 month after PCI in patients with UA were negatively correlated with EF（P0.01）.③The rates of MACE events were significantly higher in AMI patients with NT-proBNP1 205 pg/ml and UA patients with NT-proBNP265 pg/ml than those in AMI patients with NT-proBNP≤1 205 pg/ml and UA patients with NT-proBNP≤265 pg/ml,respectively.Conclusion The plasma level of NT-proBNP is correlated with the severity of coronary artery and heart function in patients with ACS,and may be used as an indicator to predict the risk of cardiovascular events with ACS after PCI.
出处
《山西医科大学学报》
CAS
2013年第1期24-28,共5页
Journal of Shanxi Medical University
基金
西安市科技计划基金资助项目[SF08001(5)]
关键词
急性冠脉综合征
急性心肌梗死
不稳定型心绞痛
N端B型脑钠肽前体
心功能
冠脉介入治疗
acute coronary syndrome
acute myocardial infarction
unstable angina
N-terminal pro-B-type natriuretic peptide
heart function
percutaneous coronary intervention
