急性心肌梗死患者急诊PCI术后ST段回落与术前血清NT-proBNP水平的相关性研究  

Correlation analysis of ST-segment resolution after PCI and serum NT-proBNP before PCI in patients with acute myocardial infarction

作　　者：杨晓仪[1] 张晓坤[1] 付玉梅[1] 黎文成[1] 张立建[1] 古雅珏[1] 

机构地区：[1]广州医科大学附属第三医院北院检验科,510000

出　　处：《检验医学与临床》2016年第14期1949-1952,共4页Laboratory Medicine and Clinic

摘　　要：目的：探讨急性心肌梗死（AMI）患者急诊冠脉介入治疗（PCI）术后ST 段回落与术前血清N末端B型脑钠肽前体（NT‐proBNP）水平的相关性。方法选择120例AMI患者为研究对象。根据术后180 minST段回落情况，分为ST段回落组（A组，n＝108）和ST段未回落组（B组，n＝12）。分析PCI术前和术后180 min血清 NT‐proBNP水平，以及术后1年主要不良心脏事件（MACE）发生情况。结果 A组患者NT‐proBNP水平[（854．3±70．2）pg／mL]低于术前[（1064．3±173．2）pg／mL]，差异有统计学意义（P＝0．031）。A组患者术后 MACE发生率（14．8％）明显低于B组患者（50．0％），差异有统计学意义（P＜0．05）。AMI患者STR程度与MACE发生率呈负相关（r＝－0．667，P＝0．005）。△NT‐proBNP与MACE呈负相关（r＝－0．551，P＝0．023），与STR呈正相关（r＝0．629，P＝0．009）。在 MACE的预测方面，△NT‐proBNP的 AUC 为0．838，95％ CI：0．714～0．893，cut‐off为65．4，敏感度88．4％，特异度83．7％；STR的AUC为0．903，95％ CI：0．834～0．953，cut‐off值为33．5，敏感度83．4％，特异度80．3％。结论 AMI患者急诊PCI术后180 minSTR与NT‐proBNP水平存在一定的相关性，两者均有助于预测M ACE。Objective To evaluate the correlation of ST‐segment resolution （STR） after percutaneous coronary intervention （PCI） and serum N‐terminal pro‐brain natriuretic peptide （NT‐proBNP） before PCI in patients with acute myocardial infarction （AMI） .Methods One‐hundred and twenty AMI patients were enrolled in this study and divided into two group based on condition of STR of 180 min after PCI treatment ：ST‐segment resolution group （group A ,n= 108） and ST‐segment not resolution group （group B ,n=12） .The levels of NT‐proBNP before and 180 min after PCI were tested .The prevalence of major adverse cardiac e‐vents （MACE） one year after PCI were also been recorded .Results The level of NT‐proBNP in group A after PCI treatment [（854 .3 ± 70 .2）pg/mL] was significantly lower than before[（1 064 .3 ± 173 .2）pg/mL]（P=0 .031） .After PCI treatment ,the inci‐dence rate of MACE in group A （14 .8% ） was significantly lower than those of group B （50 .0% ）（P〈0 .05） .For AMI patients , STR were negatively associated with MACE （r= -0 .667 ,P= 0 .005） and levels of △NT‐proBNP were negatively related with MACE（r= -0 .551 ,P=0 .023） while positively associated with STR （r=0 .629 ,P=0 .009） .ROC analysis showed that the AUC of △NT‐proBNP and STR were 0 .838 and 0 .903 ,respectively ,and cut‐off values of △NT‐proBNP and STR were 65 .4 and 33 .5 respectively .The 95% CI of the two indicators were 0 .714 -0 .893 and 0 .834 -0 .953 .The sensitivity and specificity of △NT‐proBNP were 88 .4% and 83 .7% ,which of STR were 83 .4% and 80 .3% ,respectively .Conclusion For AMI patients ,the levels of NT‐proBNP are associated with STR at time point of 180 min after PCI .Both of the indicators are useful for MACE prognosis .

关 键 词：急性心肌梗死 急诊冠脉介入治疗 ST段回落 N末端B型脑钠肽前体 

分 类 号：R542.22[医药卫生—心血管疾病]