血氨基末端脑钠素前体对急性冠状动脉综合征远期预后的评估价值  

Long term prognostic value of N-terminal pro-brain natriuretic peptide level in acute coronary syndrome

作　　者：魏盟[1] 潘晔生[1] 马士新[1] 杭靖宇[1] 金立仁[1] 

机构地区：[1]上海交通大学附属第六人民医院心内科,上海200233

出　　处：《临床心血管病杂志》2007年第10期747-750,共4页Journal of Clinical Cardiology

摘　　要：目的:观察血氨基末端脑钠素前体(NT-proBNP)对急性冠状动脉综合征(ACS)患者的远期预测价值。方法:将85例发病24h以内的ACS患者,分为ST段抬高的急性心肌梗死、非ST段抬高的急性心肌梗死和不稳定型心绞痛3组。所有病例既往均无明显心功能不全。于入院即刻、24h及1周测NT-proBNP,高敏C反应蛋白(hs-CRP),7～10d查超声心动图,记录随访1年的病死率和心血管事件住院率。结果:所有ACS患者的NT-proBNP峰值均高于正常,高峰见于入院24h。随访中病死率、所有心血管事件住院率和心力衰竭住院率分别为5.9%、17.6%、和10.6%。多因素回归分析显示hs-CRP峰值、肌酸激酶-同工酶、恶性心律失常、左室射血分数及NT-proBNP峰值是远期心血管死亡的主要危险因子,而后两者又是心力衰竭事件的预测因子。结论:NT-proBNP峰值是ACS的独立危险因子,它对ACS的远期预测价值可能要优于hs-CRP。Objective：To observe long term prognostic value of N-terminal pro-brain natriuretic peptide （ NT- proBNP） in the acute coronary syndrome（ACS） patients. Method： Eighty-five patients were enrolled in this study, all of these patients had ACS within 24 hours, they were divided into three groups（ST-elevation AMI, nonST-elevation AMI and unstable angina）. All patients hadn＇t heart failure history. NT-proBNP and high sensitive C reactive protein（hs-CRP） were examined at 0 h, 24 h and lweek after admission in all cases, and echocardiagram was also examined during the 7th to 10th day of the hospitalization. Result： NT-proBNP concentrations were high in all ACS patients, it increased rapidly to peak at 24 h. During 1 year follow up, 5（5.9%） ,15（17.6%） and 9（10.6%） patients suffered death, all cause cardiovascular hospitalization and heart failure hospitalization respectively. In multivariate analysis, the independent predictors of late cardiac death were peak hs-CRP, peak NT-proBNP, CK- MB, LVEF and severe arrythmia. But only peak NT-proBNP and LVEF were the independent predictors of late heart failure. Conclusion： NT-proBNP was a strong independent predictor for ACS, and its prognostic value maybe better than hs-CRP.

关 键 词：急性冠状动脉综合征 脑钠素 氨基末端脑钠素前体 C反应蛋白 

分 类 号：R543.3[医药卫生—心血管疾病]