NT-proBNP与MyO联合检测对高危非ST段抬高心肌梗死患者短期预后的预测价值  

Predictive value of combined detection of NT-proBNP and MyO in short-term prognosis of high-risk non ST segment elevation myocardial infarction

作　　者：王小梅 万会林 赵丹妹 WANG Xiaomei;WAN Huilin;ZHAO Danmei(Clinical laboratory,Nanjing Gaochun People's Hospital,Nanjing Jiangsu 211300,China)

机构地区：[1]南京市高淳人民医院检验科,江苏南京211300

出　　处：《中国急救复苏与灾害医学杂志》2022年第12期1548-1551,1556,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省自然科学基金青年基金(编号:BK20160231)。

摘　　要：目的研究N端脑钠肽前体(NT-proBNP)与肌红蛋白(MyO)联合检测对高危非ST段抬高心肌梗死(NSTEMI)患者短期预后的预测价值。方法选取2018年2月—2021年2月南京市高淳人民医院高危NSTEMI患者81例及同期健康体检者80例,行经皮冠状动脉介入术(PCI)治疗,根据高危NSTEMI患者术后28 d内是否发生主要不良心血管事件(MACE)分为MACE组(n=13)和非MACE组(n=68)。比较高危NSTEMI患者与健康体检者NT-proBNP、MyO水平,评估短期预后,比较两组一般资料及NT-proBNP、MyO水平,采用Logistic回归分析短期预后的影响因素,并采用受试者工作特征曲线(ROC)及曲线下面积(AUC)评估NT-proBNP、MyO水平对短期预后的预测价值。结果高危NSTEMI患者NT-proBNP、MyO水平高于健康体检者(P<0.05);81例高危NSTEMI患者中经PCI术治疗后28 d内68例未发生MACE,13例发生MACE;MACE组高脂血症占比、病变多支占比、FMC-Ballon、支架长度、NT-proBNP、MyO均高于非MACE组(P<0.05);经Logistic回归分析,高脂血症、病变支数、FMC-Ballon、支架长度、NT-proBNP、MyO均为短期预后的影响因素(P<0.05);经ROC分析显示,NT-proBNP、MyO水平预测短期预后MACE发生的Cut-off值为844.21 pg/mL、72.70μg/L,AUC值为0.826、0.889,联合检测的AUC值为0.957,特异度为98.53%。结论高危NSTEMI患者NT-proBNP、MyO水平明显异常升高,且二者是MACE发生的重要影响因素,可作为预测高危NSTEMI患者短期预后的参考指标。Objective To study the predictive value of N-terminal pro brain natriuretic peptide(NT-proBNP)and Myoglobin(MyO)in the short-term prognosis of high-risk non-ST segment elevation Myocardial infarction(NSTEMI).Methods Eighty-one patients with high-risk NSTEMI underwent percutaneous coronary intervention(PCI),followed up for 68 days,and divided into 2 groups according whether major adverse caedias event(MACE)occurred within 28 days after operation:MACE group(n=13)and non-MACE group(n=68).Related demographical and clinical data were collected.Peripheral fasting venous blood samples were collected to test the levels of NT-proBNP and MyO by automatic biochemical analyzer.Eighty healthy physical examination persons were used as controls.Logistic regression analysis was used to analyze the influencing factors of short-term prognosis,and receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to assess the predictive values of NT-proBNP and MyO levels for short-term prognosis.Results The NT-proBNP and MyO levels of the high-risk NSTEMI patients were both significantly higher than those of the physical examination persons(both P<0.05).There were no significant differences in age,gender,hypertension,diabetes,smoking history,symptom onset-to-first medical contact(SO-to-FMC),and drug use between the MACE group and non-MACE group(all P>0.05).The proportions of hyperlipidemia and multiple branches,levels of first medical contact to balloon time(FMC-to ballon),support length,NT-proBNP and MyO of the MACE group were all significantly higher than those of the non-MACE group(all P<0.05).By logistic regression analysis,hyperlipidemia,number of lesions,FMC-to-balloon time,support length,and NT-proBNP and MyO levels were all influencing factors of short-term prognosis(all P<0.05).ROC analysis showed that the cut off values of NT-proBNP and MyO to predict the short-term prognosis of MACE were 844.21 pg/mL and 72.70μg/L respectively,the AUC value was 0.826 and 0.889 respectively,the AUC value of combined dete

关 键 词：高危非ST段抬高心肌梗死 N端脑钠肽前体 肌红蛋白 短期预后 预测 

分 类 号：R542.22[医药卫生—心血管疾病]