TIMI、NT-proBNP等临床因素对AMI患者急性期MACE发生的影响  

TIMI,NT-proBNP and other clinical factors in patients with acute MACE in AMI patients

作　　者：张宏颖[1] ZHANG Hong-ying(Department of Cardiovascular Medicine, the Second People＇s Hospital of Zhengzhou , Zhengzhou, Henan 450000, Chin)

机构地区：[1]郑州市第二人民医院心血管内科,河南郑州450000

出　　处：《热带医学杂志》2017年第9期1225-1227,1262,共4页Journal of Tropical Medicine

摘　　要：目的研究心肌梗死溶栓疗法(TIMI)危险评分、血清心肌标志物及其他临床因素对急性心肌梗塞(AMI)患者急性期主要心脏不良事件(MACE)发生及预测的影响。方法随机选取2013年6月至2016年6月本院收治的急性心肌梗塞患者300例,根据患者在发病1个月内是否发生过主要心脏不良事件将患者分为发生组和不发生组,分析患者的TIMI危险评分、血清心肌标志物及其他临床因素对MACE发生与否的影响,进一步将发生过MACE的患者预后分为生存组和死亡组,分析影响患者死亡的因素。结果在300例患者中,MACE发生组196例,不发生组104例,其中纳入生存组的患者有150例,纳入死亡组的有46例,单因素分析结果为:年龄、TIMI危险评分、氨基末端脑钠肽前体(NT-proBNP)值、高血压在MACE发生组与不发生组间比较,差异均有统计学意义(P<0.05);进一步分析影响患者的死亡因素,年龄、TIMI危险评分、血清NT-proBNP、高血压为MACE患者发生死亡的危险因素,差异有统计学意义(P<0.05)。血清NT-proBNP值大于4 200 pg/m L及TIMI危险评分>9分患者死亡风险较高。结论 TIMI评分和血清心肌标记物等临床因素对临床治疗具有指导作用,患者的TIMI危险评分越高、血清NT-proBNP值越大,其发生MACE的可能性越大。Objective To investigate the effects of thrombolysis in myocardial infarction（TIMI）risk score,serum cardiacmarkers and other clinical factors on the incidence and prognosis of major adverse cardiac events（MACE） in acutemyocardial infarction（AMI）patients. Methords A total of 300 patients with acute myocardial infarction were randomlyselected from June 2013 to June 2016. According to whether the patients had major adverse cardiac events within one monthafter onset of the disease,the patients were divided into the occurrence and non-occurrence groups,the use of χ-2 test andregression analysis of patients with TIMI risk score,serum myocardial markers and other clinical factors on the occurrenceof MACE or not,and further the prognosis of MACE patients were divided into survival group and death group,The death ofpatients. Results Among the 300 patients,there were 196 cases of MACE and 104 cases of non-occurrence of MACE.Among them, 150 cases were included in the survival group and 46 cases were included in the death group. The single factoranalysis showed that： Pro BNP level, age, and hypertension were associated with the occurrence of MACE and the prognosis ofthe patients. The thresholds of MACE were 5.5 and 1 189.74 pg/m L,respectively. In addition,when the patient′s TIMIscore higher than 8.5 points, serum NT-proBNP greater than 1 613, the risk of death in patients with high. Serum NT-proBNP values greater than 4 200 pg/m L and TIMI risk score 9 patients were at higher risk of death. Conclusion TIMIscore and serum myocardial markers and other clinical factors have a guiding role in clinical treatment,the higher the riskscore of patients with TIMI,the greater the patient′s serum NT-proBNP value,the greater the possibility of the occurrenceof MACE

关 键 词：急性心肌梗塞 血清心肌标志物 主要心脏不良事件 

分 类 号：R542.22[医药卫生—心血管疾病]