血浆N氨基末端脑钠肽前体水平及QRS积分对急性ST段抬高型心肌梗死患者预后的预测价值  

Prognostic Value of Plasma N-Terminal Pro-Brain Natriuretic Peptide Level and QRS Scoring in ST-Segment Elevation Myocardial Infarction

作　　者：芦涤[1] 魏洪杰[1] 朱铭[1] 

机构地区：[1]中国石油中心医院心内科,河北廊坊065000

出　　处：《中国临床医学》2013年第1期27-28,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨血浆N氨基末端脑钠肽前体(NT-proBNP)水平及心电图QRS积分对行急诊经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者预后的预测价值。方法:采用酶联免疫吸附法检测98例行急诊PCI的STEMI患者心肌梗死1周时的血浆NT-proBNP浓度,同时评价其心电图QRS积分。按照患者在6个月内是否发生梗死后心绞痛、再梗死、心血管死亡等心血管事件。将98例患者分为心血管事件组和无心血管事件组,比较两组患者上述指标的差异。结果:心血管事件组37例,无心血管事件组61例。心血管事件组患者的NT-proBNP[(1040.8±377.2)pg/mL)]和QRS积分(6.5±0.5)与无心血管事件组[(309.9±134.2)pg/mL,4.3±0.4]相比,均显著升高(P<0.01和P<0.05)。相关性分析显示,NT-proBNP与QRS积分呈正相关(r=0.618,P<0.05)。结论:血浆NT-proBNP水平与QRS积分是反映心肌梗死后半年内患者发生心血管事件的风险的敏感指标,它可以反映STEMI患者的近期预后。Objective：To investigate the prognostic values of plasma N-terminal pro-brain natriuretic peptide（NT-proBNP） and QRS scoring in patients with ST-segment elevation myocardial infarction（STEMI） undergoing emergent percutaneous coronary intervention.Methods：A total of 98 patients with STEMI from July 2009 to July 2011 have been involved in this study.Plasma NT-proBNP levels were detected with enzyme-linked immunosorbent assay and QRS scoring was evaluated a week later after infarction.Cardiovascular events,including postinfarction angina pectoris,recurrent myocardial infarction and cardiovascular death were observed in all patients during the follow-up period of six months.Plasma NT-proBNP level and QRS scoring were compared between the cardiovascular event group and no cardiovascular event group.Results： In 98 patients,37 patients had cardiovascular events and 61 patients had no cardiovascular events.The level of plasma NT-proBNP [（1040.8±377.2） pg/mL] and QRS scoring（6.5±0.5） in cardiovascular event group were higher than those in no cardiovascular event group[（309.9±134.2） pg/mL,4.3±0.4],and the differences were significant（P0.01,P0.05,respectively）.The level of plasma NT-proBNP was positively correlated with QRS scoring（r=0.618,P0.05）.Conclusions： Plasma NT-proBNP and QRS scoring were sensitive indicators in reflecting the occurrence of cardiovascular events within six months after STEMI,and it can predict the recent prognosis of patients with STEMI.

关 键 词：N氨基末端脑钠肽前体 QRS积分 急性ST段抬高型心肌梗死 近期预后 

分 类 号：R542.22[医药卫生—心血管疾病]