急诊即时检测N-端脑钠素前体对急性冠状动脉综合征危险分层的意义  

The Significance of POCT N-terminal pro-brain natriuretic peptide Levels to Hierarchical Risk in Patients with Acute Coronary Syndromes in Emergency Department

作　　者：王子超[1] 于革文[1] 郝毅[1] 张文祥[1] 李延红[1] 

机构地区：[1]包头医学院第二附属医院,内蒙古包头014030

出　　处：《包头医学院学报》2010年第5期43-45,共3页Journal of Baotou Medical College

摘　　要：目的:探讨急诊室即时检测N-端脑钠素前体(N-terminal-proBNP,NT-proBNP)对急性冠状动脉综合征危险分层的意义。方法:选择61例急性冠状动脉综合征患者作为观察组,将观察组进一步分为急性心肌梗死组与不稳定性心绞痛组;以32例稳定性心绞痛患者为对照组。所有入选患者于入院后行冠状动脉造影术及支架置入术,对所有入选患者于术前、术后即刻及术后7d进行床边NT-proBNP即时检测,于术后1个月对所有入选患者进行主要心血管事件和NYHA心功能分级随访,并以基线NT-proBNP300pg/mL为界点进行重新分组,进一步比较NT-proBNP对MACE事件及NYHA心功能分级的影响。结果:AMI组、UA组、SA组间术前、术后即刻、术后7d时的NT-proBNP水平差异均有统计学意义(P<0.01);3组术后即刻NT-proBNP水平均高于术前,但仅在AMI组术后与术前比较差异有统计学(P<0.05);术后7dNT-proBNP水平较术前及术后即刻均降低,AMI组、UA组有统计学意义(P<0.05);基线NT-proBNP≥300pg/mL的患者术后1个月发生MACE事件率、NYHA心功能分级均高于NT-proBNP<300pg/mL的患者(P<0.05)。结论:急诊室即时检测NT-proBNP是对急性冠状动脉综合征进行危险分层的有效手段,并对其近期预后具有一定的预测价值。Objective：TO investigate the significance of POCT（point,care,testing） N-terminal pro-brain natriuretic peptide（NT-proBNP） levels to hierarchical risk in patients with acute coronary syndromes in emergency department.Methods：61 cases of acute coronary syndrome（ACS） were divided into the acute myocardial infarction（AMI） group and the unstable angina（UA） group,and 32 cases of stable angina（SA） serve as the control group.Coronary angiography（C/A） and percutaneous coronary intervention（PCI） were performed in all cases.Bedside testing of NT-proBNP was offered to all cases before C/A,immediately and 7 days after PCI.Main adverse cardiovascular events（MACE） and cardiac function were followed up within 1 month in all cases,furthermore,the MACE events and the NYHA functional class were compared by preoperative NT-proBNP 300 pg/mL cut-off for the community.Results：POCT NT-proBNP levels were 898.7 ±329.3pg/ml,362.1 ±129.3 pg/mL,93.5 ±49.2 pg/mL before C/A in AMI and UA and SA group respectively（P 〈0.01）.POCT NT-proBNP levels were 1 042.9 ±428.6 pg/mL,383.6 ± 144.2 pg/mL,96.8 ±48.6 pg/mL immediately after PCI in the AMI and UA and SA group,respectively（P 〈0.01）.POCT NT-proBNP levels were 562.1 ±219.6 pg/mL,285.7 ±94.6 pg/mL,90.1 ±45.3 pg/mL 7days after PCI in the AMI and UA and SA group,respectively（P 〈0.01）.POCT NT-proBNP levels immediately after PCI were higher than those before PCI in all groups,but there were preoperative statistical differences only in the AMI group（P 〈0.05）.POCT NT-proBNP levels 7 days after PCI were lower than those immediately after PCI in all groups,but there were preoperative statistical differences only in the AMI and UA group（P 〈0.05）.MACE rate was 9.6 %（5/52） in patients with baseline NT-proBNP ≥300 pg/mL,higher than that（2/41） in patients with basicline NT-proBNP 〈300 pg/mL（P 〈0.05）.NYHA functional class was 1.97 ±0.52 in patients with baseline NT-proBNP ≥300 pg/ml,worse than that（1.48 ± 0.48

关 键 词：N-端脑钠素前体 即时检测 急性冠状动脉综合征 危险分层 

分 类 号：R541.4[医药卫生—心血管疾病]