氨基末端B型利钠肽原与非糖尿病急性心肌梗死合并应激性高血糖相关性研究  

Correlation Study of Plasma Level NT-ProBNP in Patients With Non-diabetic Acute Myocardial Infarction Combining Stress Hyperglycemia

作　　者：童随阳 夏豪[1] 王欣[1] 李磊[1] 王慧[1] 黄丹[1] 

机构地区：[1]武汉大学人民医院心内科,湖北省武汉市430060

出　　处：《中国循环杂志》2015年第1期9-12,共4页Chinese Circulation Journal

基　　金：国家自然科学基金(81270184)

摘　　要：目的:探讨氨基末端B型利钠肽原(NT-pro BNP)与非糖尿病急性心肌梗死(AMI)合并应激性高血糖相关性。方法:选取2012-02至2014-05在我院心内科住院诊断为非糖尿病AMI的患者327例,按空腹血糖水平分为非糖尿病AMI合并应激性高血糖组(应激组)182例和非糖尿病AMI未合并应激性高血糖组(非应激组)145例。统计患者基本临床资料及入院24 h内实验室检查、超声心动图及24小时动态心电图检查结果,并记录住院2周内心律失常、心力衰竭、心原性休克、心原性猝死等主要不良心血管事件发生率,分析NT-proBNP与非糖尿病AMI合并应激性高血糖的相关性。结果:年龄、性别、高血压史、吸烟史、饮酒史、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)在应激组和非应激组之间比较差异无统计学意义(P<0.05),NT-proBNP、肌酸激酶MB同工酶(CK-MB)、肌红蛋白(MYO)、超敏肌钙蛋白I(ultra-TnI)、丙氨酸氨基转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、血糖(Glu)在应激组和非应激组之间比较差异有统计学意义(P<0.01)。NT-pro BNP与ultra-TnI呈正相关(r2=0.811,P<0.01)。应激组主要心血管不良事件发生率明显高于非应激组(P<0.05);左心室射血分数(LVEF)明显低于非应激组(P<0.01);左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)明显高于非应激组(P<0.01),差异均有统计学意义。结论:NT-proBNP水平可以判断非糖尿病AMI合并应激性高血糖患者病情危重程度,并对近期预后做出评估。Objective： To explore the correlation of plasma level N-terminal pro-B-type natriuretic peptide （NT-proBNP） in patients with non-diabetic acute myocardial infarction （AMI） combining stress hyperglycemia. Methods： A total of 327 non-diabetic AMI patients treated in our hospital from 2012-02 to 2014-05 were studied. The patients were divided into 2 groups according to fasting blood glucose level：Stress group, the patients with blood glucose≥7.0 mmol/L, n=182 and Non-stress group, the patients with blood glucose〈7.0 mmol/L, n=145. The basic clinical condition, laboratory tests within 24 hours of onsets, echocardiography and 24 h dynamic electrocardiogram were examined;the incidence of major adverse cardiovascular events （MACE） including arrhythmia, heart failure, cardiac shock and sudden cardiac death in 2 weeks of onsets were analyzed and compared between 2 groups. Results： The patients’ age, gender, history of hypertension, smoking, drinking, and blood levels of TC, TG, HDL-C, LDL-C were similar between 2 groups, P＆gt;0.05. Plasma levels of NT-proBNP, CK-MB, MYO, ultra-TnI, ALT, AST and blood glucose level were signiifcantly different between 2 groups P〈0.01. NT-proBNP level was positively related to ultra-TnI （r2=0.811, r=0.901, P〈0.01）. Stress group presented obviously higher incidence of MACE （P〈0.05）, lower LVEF （P〈0.01）, and signiifcantly increased left ventricular end diastolic diameter, left ventricular end systolic diameter （P〈0.01） than those in Non-stress group. Conclusion： Plasma levels of NT-proBNP may judge the severity and evaluate recent prognosis in patients with non-diabetic AMI combining stress hyperglycemia, it could be used as a risk indicator for relevant patients in clinical practice.

关 键 词：氨基末端B型利钠肽原 急性心肌梗死 应激性高血糖 相关性 

分 类 号：R54[医药卫生—心血管疾病]