OPCABG患者围手术期NT-ProBNP水平变化及其临床意义  

Change and significance of perioperative N-terminal pro-brain natriuretic peptide in patients undergoing off-pump coronary artery bypass grafting

作　　者：顾畅[1] 张蔚然[2] 庄玲芳 徐骁晗[2] 张杨杨[2] 

机构地区：[1]南京医科大学第一临床医学院,江苏省210029 [2]南京医科大学第一附属医院胸心外科

出　　处：《江苏医药》2014年第14期1659-1662,共4页Jiangsu Medical Journal

摘　　要：目的探讨非体外循环冠状动脉旁路移植术(OPCABG)患者围手术期血浆脑钠肽前体(NT-proBNP)水平的变化及其临床意义。方法 OPCABG患者134例分为老年组(≥65岁,74例)和中年组(<65岁,60例)。检测术前2d和术后1、2、4、7d的血浆NT-proBNP水平。结果患者术前NT-proBNP水平与左室射血分数(EF)(r=-0.443,P<0.01)、心功能分级(r=0.181,P<0.05)、冠心病分类(r=0.191,P<0.05)和术后1d的NT-proBNP水平(r=0.557,P<0.01)均显著相关。两组患者术后NT-proBNP水平均升高(P<0.05);老年组术后4、7dNT-proBNP高于中年组(P<0.05)。结论 OPCABG患者术前NT-proBNP水平与术前EF、心功能分级、冠心病分类等因素密切相关;术后NT-proBNP水平明显升高,老年患者尤为明显。Objective To discuss the change and significance of plasma perioperative N-terminal pro-brain natriuretic peptide（NT-proBNP） in the patients undergoing off-pump coronary artery bypass grafting（OPCABG）. Methods A total of 134 patients undergoing OPCABG was divided into 2 groups of A≥65 years old,74 cases） and B〈65 years old, 60 cases）. Plasma levels of NT-proBNP were detected 2 days before and on the Ist , 2nd , 4th and 7th day after surgery. Results Plasma levels of NT-proBNP before surgery were significantly correlated with preoperative left ventricular ejection fraction （EF） （ r= -0. 443, P〈0. 01 ）, heart function classification （ r=0. 181, P〈0. 05 ）, coronary heart disease classification（r=0. 191 ,P〈0. 05）,and plasma level of NT-proBNP on the 1st day after surgery （r=0. 557, P〈0. 01）. Plasma levels of NT-proBNP were significantly higher after surgery than those before in both groups（P〈0. 05） ,which on the 4th and 7th day after surgery were higher in group A than those in group B（P〈0. 05）. Conclusion Plasma levels of NT-proBNP before surgery are closely related to the EF, heart function classification and coronary heart disease classification. Plasma levels of NT-proBNP are increased in the patients undergoing OPCABG, especially in the elderly.

关 键 词：非体外循环冠状动脉旁路移植术 脑钠肽前体 

分 类 号：R654[医药卫生—外科学]