摘要
目的探讨N末端脑钠肽前体(NT-proBNP)对急性ST段抬高型心肌梗死(STTAMI)患者经皮冠状动脉介入(PCI)术后1年内心血管事件的预测价值。方法选择直接PCI治疗的STEAMI患者126例,测定NT-proBNP水平、肌酸激酶同工酶、心肌肌钙蛋白I(cTnI),记录1年内心血管事件的发生情况,根据有无心血管事件分为事件组(38例)和非事件组(88例)。结果事件组年龄、NT-proBNP、Gensini积分、三支病变构成比、糖尿病构成比明显高于非事件组(P<0.05);入院后48 h内NT-proBNP水平预测心血管事件阈值定为870 pg/ml时,其敏感度为78.9%(30/38),特异度为70.5%(62/88),阳性预测值为53.6%(30/56),阴性预测值为88.6%(62/70),准确率为73.0%(92/126)。以870 pg/ml为分界点将患者分为高NT-proBNP组(56例)和低NT-proBNP组(70例),2组心血管事件发生率分别为53.6%(30/56)和11.4%(8/70),差异有统计学意义(P<0.01)。高NT-proBNP组的冠状动脉近段病变、三支病变构成比均较低NT-proBNP组高(46.4%vs.17.2%,32.1%vs.12.9%,P<0.01),Gensini积分亦明显高于低NT-proBNP组[(78.4±13.7)分vs.(45.3±11.3)分,P<0.01]。运用Logistic回归分析,只有年龄、NT-proBNP、糖尿病、Gensini积分是1年内发生心血管事件的独立预测因子。结论NT-proBNP对预测STEAMI患者1年内的心血管事件具有重要价值。
Objective To investigate the prognostic value of N-terminal pro brain natriuretic peptide（NT-proBNP）on 1 year cardiovascular events in acute ST segment elevation myocardial infarction（STEAMI） patients with PCI after operation.Methods One hundred and twenty-six patients with STEAMI and treated with PCI were enrolled,the level of NT-proBNP,creatine kinase isoenzymes,cardiac troponin I were measured,the occurrence of 1 years cardiovascular events were recorded,according to the heart vascular events,patients were divided into event group（38 cases） and nonevent group（88 cases）.Results In event group,age,NT-proBNP,Gensini integral,three vessel disease constituent ratio,diabetes constituent ratio is significantly higher than that of nonevent group（P〈0.05）;admission within 48 h,the threshold of NT-proBNP levels to predict cardiovascular events is 870 pg/ml with sensitivity of 78.9%（30/38）,the specificity was 70.5%（62/88）,the positive predictive value was 53.6%（30/56） and the negative predictive value was 88.6%（62/70）,the accuracy rate was 73.0%（92/126）.With 870 pg/ml as the cutoff points,patients were divided into high NT-proBNP group（56 cases）and low NT-proBNP group（70 cases）,2 groups of cardiovascular event rates were 53.6%（30/56） and 11.4%（8/70）,the difference was statistically significant（P〈0.01）.The proximal segment of coronary artery lesion and constituent ratio of three vessel lesion in high NT-proBNP group were lower than in NT-proBNP group（46.4%vs.17.2%,32.1%vs.12.9%,P〈0.01）,the Gensini score in high NT-proBNP group was also significantly higher than the low NT-proBNP group[（78.4 ±13.7） vs.（45.3 ± 11.3）,P〈0.01].Using Logistic regression analysis,only age,NT-proBNP,diabetes,Gensini score are independent predictors of 1 year cardiovascular events.Conclusion NT-proBNP have important value in prediction of 1 year cardiovascular events in STEAMI patients.
出处
《疑难病杂志》
CAS
2014年第12期1233-1235,1239,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
N末端脑钠肽前体
急性心肌梗死
ST段抬高型
心血管事件
预测价值
N-terminal pro brain natriuretic peptide
acute myocardial infarction
ST elevation
Cardiac events
Predictive value
