左心室射血分数正常的急性ST段抬高型心肌梗死患者氨基末端B型利钠肽原水平与冠状动脉病变的关系  

Relationship Between Plasma NT-proBNP Level and Coronary Artery Lesions in Acute ST-elevation Myocardial Infarction Patients With Normal Left Ventricular Ejection Fraction

作　　者：江冠颖 赵玉兰[1] 董静[1] 黄亚萍[1] JIANG Guan-ying ZHAO Yu-lan DONG Jing HUANG Ya-ping(Department of Cardiology, the Second Hospital of Zhengzhou University, Zhengzhou 450000, Henan, Chin)

机构地区：[1]郑州大学第二附属医院心内科,河南省郑州市450000

出　　处：《中国循环杂志》2017年第2期137-140,共4页Chinese Circulation Journal

摘　　要：目的:探讨左心室射血分数(LVEF)正常的且无明显舒张性心力衰竭症状的急性ST段抬高型心肌梗死(STEMI)患者血浆氨基末端B型利钠肽原(NT-proBNP)浓度与冠状动脉(冠脉)狭窄程度、冠脉病变数量及左前降支病变的关系。方法:收集符合条件的STEMI患者280例,在入院24 h内检测其血浆NT-proBNP浓度,并对其根据Gensini评分系统评估冠脉病变狭窄严重程度,分为Gensini评分<30分组(n=94),Gensini评分30~60分组(n=87),Gensini评分>60分组(n=99);根据冠脉病变的数量分为单支病变组(n=78)、双支病变组(n=105)及三支病变组(n=97);根据罪犯血管是否为前降支分为前降支组(n=146)和非前降支组(n=134),对各组结果进行比较分析。结果:血浆NT-proBNP浓度Gensini评分>60分组显著高于Gensini评分<30分组和Gensini评分30~60分组,Gensini评分30~60分组显著高于Gensini评分<30分组;冠脉病变的支数越多,血浆NT-proBNP浓度越高(pg/ml,336.90±176.70vs 608.70±331.20 vs 1176.70±492.50);前降支组血浆NT-proBNP浓度高于非前降支组(pg/ml,1199.40±725.00 vs607.40±244.20),上述比较差异均有统计学意义(P<0.05)。血浆NT-proBNP浓度与Gensini积分Pearson相关分析显示两者呈正相关(r=0.278,P<0.05)。结论:STEMI患者血浆NT-proBNP浓度与冠脉病变严重程度呈正相关,对其三支血管病变及前降支血管是否为罪犯血管具有一定预测价值,常规检测NT-proBNP浓度有助于STEMI患者的危险分层及临床诊疗。Objective： To study the relationship between plasma NT-ProBNP level and the severity of coronary artery lesions including left anterior descending （LAD） involvement in acute ST-elevation myocardial infarction （STEMI） patients with normal left ventricular ejection fraction （LVEF） while without diastolic heart failure. Methods： A total of 280 qualiifed patients were collected, plasma NT-proBNP level was examined in all patients within 24-hour of admission. The patients were divided into 3 sets of groups. By Gensini score system： Gensini score〈30 group, n=94, Gensini score （30-60） group,n=87 and Gensini score〉60 group,n=99; by the number of coronary branch lesions： Single branch group,n=78, Double branch group,n=105 and Triple branch group,n=97; by LAD condition： Criminal LAD group,n=146 and Non-criminal LAD group,n=134. Relevant comparison was conducted in all patients. Results： Plasma NT-proBNP level in Gensini score〉60 group was higher than the other 2 Gensini groups, it was higher in Gensini score （30-60） group than Gensini score〈30 group; the more branches were involved, the higher NT-proBNP were found （1176.70±492.50） pg/ml vs （608.70±331.20） pg/ml vs （336.90±176.70） pg/ml; NT-proBNP was higher in Criminal LAD group than Non-criminal LAD group （1199.40±725.00） pg/ml vs （607.40±244.20） pg/ml, allP〈0.05. Pearson correlation analysis showed that NT-proBNP was positively related to Gensini score （r=0.278,P〈0.05）. Conclusion： Plasma NT-proBNP level was positively related to severity of coronary lesions, it had certain predictivevalue for triple vessel disease and criminal LAD; routine NT-proBNP examination was helpful for risk stratiifcation and clinical treatment in acute STEMI patients.

关 键 词：心肌梗死 利钠肽 脑 GENSINI积分 

分 类 号：R541[医药卫生—心血管疾病]