急性心肌梗死患者血浆NT-proBNP水平与心肌坏死程度及近期预后的关系  

Correlation of serum N-terminal pro-BNP level with severity of myocardial necrosis and short-term prognosis in patients with acute myocardial infarction

作　　者：侯琳琳[1] 王邦宁[2] 高潮[1] 陈振飞[1] 冯俊[1] 

机构地区：[1]合肥市第二人民医院心内科,230011 [2]安徽医科大学第一附属医院CCU

出　　处：《浙江医学》2016年第7期479-481,共3页Zhejiang Medical Journal

摘　　要：目的探讨急性心肌梗死（AMI）患者入院时血浆N末端脑钠肽前体（NT—proBNP）水平与心肌坏死程度及近期预后的关系。方法检测86例AMI患者和40例冠状动脉造影正常的胸痛患者入院时血浆NT-proBNP水平。记录患者入院时Killip分级、心肌肌钙蛋白T（cTnT）峰值，计算患者发病后5～7d的心电图QRS积分，同期进行超声心动图检查并记录左心室射血分数（LVEF）、左心室舒张末期内径（LVEDd）。随访患者6个月，记录随访期间发生的心源性死亡、再发心肌梗死和因心力衰竭再入院情况。结果AMI组患者血浆NT—proBNP水平经对数转换后为2．514-063，较对照组（189±0．44）高，差异有统计学意义（t=3884，P〈001）。多元逐步回归分析显示NT—proBNP水平与QRS积分独立相关（r=0001，P〈0．05）。多因素logistic回归分析显示，NT—proBNP≥150ng／ml是AMI患者发病6个月再发心肌梗死（OR=2．421，95％CI：1．155～5700，P〈0．05）和心力衰竭（OR=2．114，95％CI：1．501～6105，P〈005）的独立危险因素。结论AMI患者入院时血浆NT—proBNP水平与心肌梗死面积及近期预后相关。Objective To investigate the association of N-terminal pro-B-type natriuretic peptide（NT-proBNP） with the severity of myocardial necrosis and short-term prognosis in patients with acute myocardial infarction （AMI）. Methods Eighty six patients with acute myocardial infarction and 40 controls were included in this study. NT-proBNP concentration was measured at admission. Killip classification and the peak of cTnT were recorded; QRS score was calculated according to ECG 5-7d after AMI; UCG was performed to evaluate LVEF and LVEDd. All patients were followed up for 6 months. Cardiac death, recurrent myocardial infarction and readmission due to heart failure were documented. Results The level of LgNT-proBNP in AMI patients was significantly higher than controls （2.51 ± 0.63 vs 1.89 ± 0.44, t=3.884, P〈0.01）. Multiple stepwise regression analysis showed that NT-proBNP level was significantly correlated with QRS score by （r=0.001, P〈0.05） . Logistic regression analysis demonstrated that NT-proBNP ≥ 150ng/ml was a independent risk factor for recurrent myocardial infarction （OR=2. 421, 95% CI：1.155 - 5.700, P〈0.05）and heart failure （OR=2.114, Conclusion The plasma NT-proBNP level is correlated with the size 95%CI： 1.501-6.105, P〈0.05）during 6-month follow-up. of myocardial infarction and the short-term prognosis in A- MI patients.

关 键 词：N末端脑钠肽前体 急性心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]