N末端脑钠肽联合GRACE评分对非ST段抬高型急性冠脉综合征患者的远期预测  

Predictive value of B-type natriuretic peptide combined with GRACE risk score for the long-term prognosis in patients with non-ST elevation acute coronary syndrome

作　　者：曹荣元[1] 赵思源[1] 顾遵才[1] 张淑花[1] 王正忠[1] 孙黎明[1] 

机构地区：[1]江苏省连云港市第二人民医院心血管内科,江苏连云港222023

出　　处：《中国医药导报》2016年第32期65-68,共4页China Medical Herald

摘　　要：目的探讨N末端脑钠肽（NT-pro BNP）联合全球冠状动脉事件注册（GRACE）评分与非ST段抬高型急性冠脉综合征（NSTE-ACS）患者远期预后的相关性。方法选取2013年1月~2015年1月在江苏省连云港市第二人民医院心内科诊断为NSTE-ACS的患者77例。患者入院24 h内测定NT-pro BNP水平,计算GRACE评分。出院后对患者进行12个月的随访,将随访期间发生不良心血管事件的患者作为事件组（n=9）,未发生心血管事件的患者作为非事件组（n=68）。观察NT-pro BNP水平及GRACE评分对不良心血管事件的影响。结果研究发现事件组患者NT-pro BNP水平明显高于非事件组患者,差异有高度统计学意义（P〈0.01）;事件组患者的GRACE风险评分明显高于非事件组患者（P〈0.05）。Logistic回归分析表明：NT-pro BNP水平和GRACE评分是NSTE-ACS患者远期不良心血管事件发生的独立预测因素（P〈0.05）。在预测NSTE-ACS患者12个月不良心血管事件发生的受试者工作特征（ROC）曲线中,NT-pro BNP水平的曲线下面积为0.824（95%CI：0.774~0.848,P〈0.01）,GRACE评分的曲线下面积为0.793（95%CI：0.743~0.829,P〈0.01）,两项联合的曲线下面积为0.833（95%CI：0.788~0.879,P〈0.01）。结论 NT-pro BNP和GRACE评分是预测NSTE-ACS患者远期预后的可靠指标;NT-pro BNP联合GRACE评分能提高评估NSTE-ACS患者远期预后的能力。Objective To investigate the correlation of the N-terminal pro-brain natriuretic peptide（NT-pro BNP） and global registered acute events（GRACE） risk score in patients with non-ST elevation acute coronary syndrome（NSTEACS） for long-term prognosis. Methods From January 2013 to January 2015, in the Second People＇s Hospital of Lianyungang, 77 cases of patients with NSTE-ACS were selected. The level of NT-pro BNP was measured and GRACE score was calculated in 24 h admitted to hospital. After discharge, patients were followed up for 12 months. According to the incidence of adverse cardiovascular events during the follow-up period, all patients were divided into two groups：event group（n=9） and non event group（n=68）. The effects of NT-pro BNP level and GRACE score on adverse cardiovascular events were observed. Results The study found that the level of NT-pro BNP in patients of the event group was significantly higher than that of patients in the non event group, the difference was statistically significant（P〈0.01）.The GRACE risk score of the event group was significantly higher than that of the non event group（P〈0.05）. Logistic regression analysis showed that NT-pro BNP level and GRACE score were independent predictors of long-term adverse cardiovascular events in patients with NSTE-ACS（P〈0.05）. The prediction of receiver operating characteristic curve（ROC） showed that the area under the curve of NT-pro BNP was 0.824（95%CI： 0.774-0.848, P〈0.01）, the area under the curve of GRACE score was 0.793（95%CI： 0.743-0.829, P〈0.01）, the two joint area under the curve was 0.833（95%CI： 0.788-0.879, P〈0.01）. Conclusion NT-pro BNP level and GRACE score are reliable indicators for predicting long-term prognosis of patients with NSTE-ACS. The combination of GRACE score and NT-pro BNP can improve the prediction of the long-term prognosis.

关 键 词：N末端脑钠肽 GRACE评分 非ST段抬高型急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]