B型钠尿肽在非ST段抬高急性冠状动脉综合征患者中的应用  

The use of B-type natriuretic peptide in patients with non-ST-elevation acute coronary syndrome

作　　者：焦媛[1] 李宪伦[1] 王勇[1] 杨鹏[1] 刘晓飞[1] 张虎[1] 郑金刚[1] 曾玉杰[1] 柯元南[1] 

机构地区：[1]卫生部中日友好医院心内科,北京100029

出　　处：《中华老年心脑血管病杂志》2010年第3期227-229,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的分析非ST段抬高急性冠状动脉综合征(non-ST elevation acute coronary syndrome,NSTE-ACS)患者B型钠尿肽水平(B-type natriuretic peptide,BNP)的变化与LVEF的相关性,评估BNP在NSTE-ACS患者近期心功能中的预测作用。方法入选NSTE-ACS患者138例,依据入院后治疗方式分为:6 h内PCI组(组1,47例),5～7 d PCI组(组2,50例),药物保守治疗组(组3,41例)。所有患者于入院即刻、发病48 h及7 d时,测定静脉血清BNP,1个月后测LVEF,比较不同时间点BNP的差异,分析BNP水平与1个月后LVEF的关系。结果 3组患者入院即刻和发病48 h时BNP水平差异无统计学意义(P=0.086、0.279);发病7 d时,与组2和组3比较,组1BNP水平显著下降(P=0.006、0.001);组2与组3比较,差异无统计学意义(P=0.052)。发病7 d BNP水平与1个月后LVEF呈显著负相关(r=-0.56,P<0.01)。结论在NSTE-ACS患者中,早期介入治疗可以显著降低发病7 d时BNP水平,BNP水平与近期心功能状态呈显著负相关。Objective To analyze change in plasma B-type natriuretic peptide（BNP） levels in patients with non-ST-elevation acute coronary syndrome （NSTE-ACS） and its relationship with left ventricular ejection fraction（LVEF）. Methods 138 consecutive patients with NSTE-ACS were enrolled. They were divided into 3 groups.group 1 （received PCI within 6 hours from the onset, n = 47）;group 2（received PCI 5-7 d after the onset, n = 50）;group 3（received medicine therapy, n = 41）. Serum BNP concentration was examined on admission,48 hours and 7 days from the onset,respectively. All patients were followed up for 1 month by echocardiography. Results BNP levels were significantly lower in group 1 than those in group 2 and group 3 on 7th day from the onset （P〈 0.05）. BNP levels on 7th day from the onset showed a significant negative correlation with LVEF in 1 month follow-up （r =- 0.56,P 〈 0.01）. Conclusion BNP levels are decreased in patients with NSTE-ACS receiving early PCI. Elevation of BNP is associated with abnormal LVEF.

关 键 词：利钠肽 脑 急性冠状动脉综合征 每搏输出量 心室功能障碍 左 预后 

分 类 号：R541.4[医药卫生—心血管疾病]