B型利钠肽与急性心肌梗死患者预后的关系  

Relationship between Plasma Level of B-type Natriuretic Peptide and the Prognosis of Patients with Myocardial Infarction

作　　者：沈海英[1] 李琼[2] 朱雪明[1] 

机构地区：[1]苏州大学附属第二医院检验科,江苏苏州215004 [2]江苏大学医学技术学院

出　　处：《中国血液流变学杂志》2007年第1期139-141,共3页Chinese Journal of Hemorheology

摘　　要：目的探讨B型利钠肽(BNP)浓度与急性心肌梗死(AMI)患者预后的关系。方法采用酶联免疫吸附法(ELISA)测定49名健康对照者和80例AMI患者急性期的血浆BNP浓度,并对AMI患者在住院期及随后平均16个月进行随访,观察其预后状况。结果AMI患者发作期血浆BNP浓度(1784.40±1593.40ng/L)显著高于正常对照组(72.93±32.32ng/L),两者之间的差异有显著意义(P<0.01)。随访结果显示,其后心血管事件发生组在AMI期间的BNP浓度(2230.81±870.28ng/L)明显高于未发生组(1374.50±1011.42ng/L),差异有显著意义(P<0.05);并且BNP浓度越高,再发心血管事件的机率越大,BNP浓度<1 500ng/L,其心血管事件发生率为30%,BNP浓度1 500～3 000ng/L,心血管事件发生率42.86%,BNP浓度>3 000ng/L,心血管事件发生率62.5%,且各组间差异有统计学意义(P<0.05)。logistic多元回归分析显示BNP浓度是心血管事件发生的危险因子。结论BNP浓度与AMI患者的预后有着密切的关系,发生心血管事件组的BNP浓度显著高于未发生组,并且BNP浓度越高其发生心血管事件的概率越高,BNP可作为AMI后心血管事件发生的独立预测因子。Objective To explore the value of B-type natriuretic peptide （BNP） in estimating the risk in patients with acute myocardial infarction （AMI） and determining the relationship between BNP and adverse cardiac events after AMI.Methods The study included 80 AMI patients and 49 healthy subjects （with normal heart function）.Plasma BNP level was measured by ELISA.Patients were followed to survey the prognosis （have cardiac events or not） next 16 months. Results Plasma BNP concentration in AMI patients was much higher than healthy subjects（1784.40 ± 1593.40 ng/L versus 72.93 ± 32.32ng/L, P〈0.05）. Patients had cardiac events after AMI,the BNP concentration was higher than those no cardiac events patients（2230.81 ± 1870.28ng/L versus 1374.50 ± 1011.42ng/L,P〈0.05）.With the concentration of BNP increasing, the probability of cardiac events occurring is rising. When the BNP concentration〈1500ng/L,the probability is 30%, when its 1 500-3000ng/L, the probability is 42.86%, and the concentration〉3 000ng/L, the probability rises to 62.5 %,the positive rate of these three group have difference （P〈0.05）.The data of logistic analysis show that BNP is a risk factor of poor outcomes in AMI patients.Conclusion The results of the present study confirm that the elevated BNP concentration related to the bad prognosis in patients with AMI and a higher incidence of new cardiac events after AMI. With the concentration of BNP rising, the probability of cardiac events occurring was higher. It can be used as an independent predictor of poor outcomes in AMI patients.

关 键 词：B型利钠肽 心肌梗死 预后 

分 类 号：R446.11[医药卫生—诊断学] R542.22[医药卫生—临床医学]