STEMI患者脑钠肽与近期预后关系  

Relationship between B-type natriuretic peptide and short-term prognosis in nondiabetic patients with ST-segment elevation myocardial infarction

作　　者：魏鹏[1] 付强[1] 王彦炯[1] 吴强[1] 王海波[1] 路雯[1] 白洁[2] 张倩[3] 钟健[3] 

机构地区：[1]徐州市中心医院心内科,徐州221009 [2]解放军第二军医大学附属长海医院老年科 [3]江苏大学临床医学院

出　　处：《中国循证心血管医学杂志》2014年第3期336-338,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨不同部位ST段抬高型心肌梗死(STEMI)患者脑钠肽(BNP)水平的差异及BNP水平与近期预后的关系。方法纳入2012年6月～2013年6月徐州市中心医院心内科首次入院接受冠状动脉造影检查的STEMI患者124例,结合心电图及冠脉造影(CAG)结果,将患者分为三组,即前壁、高侧壁心肌梗死组53例(A组),下、后壁心肌梗死组41例(B组),右心室心肌梗死组30例(C组),同期纳入CAG正常患者30例作为对照组(D组),比较各组BNP水平差异。将所有患者再按照BNP水平分为:BNP正常组(<100 ng/ml)36例、轻度升高组(100～400 ng/ml)61例、显著升高组(≥400 ng/ml)27例,比较各组6个月内MACE事件(继发心力衰竭、严重心律失常、梗死后心绞痛、再发心肌梗死、心源性死亡)发生率的差异。结果 A组、B组、C组、D组患者,BNP水平呈现逐渐降低趋势[分别为:(305.17±112.63)pg/ml、(201.38±72.54)pg/ml、(157.43±79.18)pg/ml、(39.49±15.07)pg/ml],各组间差异均有统计学意义(P<0.05);除BNP正常组和轻度组心源性死亡率无统计学差异(P>0.05),其余不同BNP水平组间MACE事件发生率比较,差异均有统计学意义(P<0.05),MACE事件发生率在BNP正常组、轻度组、显著升高组呈现增高趋势。结论 BNP水平可作为临床上评价STEMI患者近期预后危险程度的指标。Objective To investigate the difference in the level of B-type natriuretic peptide （BNP） and relationship between BNP and short-term prognosis in the patients with ST-segment elevation myocardial infarction （STEMI）. Methods The patients with STEMI [n=124, firstly being hospitalized and accepting coronary angiography （CAG）] were chosen from the Central Hospital of Xuzhou City, and according to the outcomes of ECG and CAG, they were divided into group A （n=53）, group B （n=41） and group C （n=30）, and other patients with normal CAG （n=30） were chosen as group D （control group）. The level of BNP was compared among all groups. All patients were divided again, according to the level of BNP, into normal BNP group （〈100 ng/mL, n=36）, mild-higher BNP group （100-400 ng/mL, n=61 group） and marked-higher BNP group （≥400 ng/mL, n=27）. The incidence of major adverse cardiovascular events （MACE, including secondary heart failure, severe arrhythmia, post-infarction angina, relapse myocardial infarction and cardiac death） was compared among all groups within 6 months. Results The level of BNP showed a gradual decreasing trend [（305.17±112.63） pg/mL, （201.38±72.54） pg/mL, （157.43±79.18） pg/mL, （39.49±15.07） pg/mL] in group A, group B, group C and group D （P〈0.05）. The comparison in MACE incidence showed that there was no statistical difference between normal BNP group and mild-higher BNP group （P〉0.05）, and there was statistical difference among all other BNP groups （P〈0.05）. The incidence of MACE showed an increasing trend in normal BNP group, mild-higher BNP group and marked-higher BNP group. Conclusion The level of BNP can be taken as a clinical index for reviewing the short-term prognosis in the patients with STEMI.

关 键 词：ST段抬高型心肌梗死 急性冠状动脉综合征 脑钠肽 主要心脏不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]