血浆NT-ProBNP与AMI冠脉病变程度的相关性及对心力衰竭的预测价值研究  

Correlation between plasma NT-proBNP and the degree of coronary artery disease in acute myocardial infarction and its predictive value for heart failure

作　　者：袁丽霞 张亚琦 YUAN Li-xia;ZHANG Ya-qi

机构地区：[1]郑州市中心医院心血管内科病区,河南郑州470000 [2]平顶山市第二人民医院心内四科,河南平顶山467000

出　　处：《中国疗养医学》2024年第6期104-108,共5页Chinese Journal of Convalescent Medicine

基　　金：河南省医学科技攻关项目(LHGJ2020021837)。

摘　　要：目的 观察血浆N末端B型利钠肽原(NT-ProBNP)水平与急性心肌梗死(AMI)患者冠脉病变程度的相关性及对患者心力衰竭(HF)的预测效能。方法 本文为回顾性研究,病例纳入时间为2021年5月至2023年1月,研究对象为121例AMI患者,依据冠脉造影结果,将31例仅有1支血管病变患者列为轻度组,将45例有2支血管病变患者列为中度组,将45例有3支血管病变患者列为重度组,比较三组患者的NT-ProBNP水平及冠脉病变Gensini评分结果,经Spearman相关性系数验证NT-ProBNP水平与AMI患者冠脉病变程度的相关性。根据是否合并HF,将121例患者分为合并组、未合并组,统计合并组的HF发作类型,比较两组患者的临床资料,经多元回归分析归纳可导致AMI患者发生HF的危险因素;通过绘制受试者工作特征曲线(ROC)并观察线下面积(AUC)验证各危险因素对AMI患者发生HF的预测效能。结果 经检测,重度组患者的NT-ProBNP水平为(145.25±20.33)pg/mL,Gensini评分为(34.41±5.21)分,均高于中度组[(126.77±20.41)pg/mL、(31.22±5.17)分]、轻度组[(112.24±20.16)pg/mL、(28.44±5.31)分],差异具有统计学意义(P<0.05)。经Spearman相关性系数检验,AMI患者的NT-ProBNP表达水平和Gensini评分呈显著正相关。多元回归分析结果显示,心率(HR)≥75次/min、左房内径(LAD)≥35 mm、NT-ProBNP>125 pg/mL为AMI患者发生HF的危险因素。ROC曲线显示,NT-ProBNP对AMI发生HF的预测敏感度、特异度均高于年龄、HR、LAD。结论 NT-ProBNP表达水平与AMI患者冠脉病变程度密切相关,NT-ProBNP>125 pg/mL对AMI患者并发HF具有较高预测效能。Objective To identify the correlation between plasma N-terminal pro-B-type natriuretic peptide(NT-ProBNP)and the degree of coronary artery disease in acute myocardial infarction(AMI)patients,and to illustrate its predictive efficiency on heart failure(HF).Methods This was a retrospective study involving 121 AMI patients included from May 2021 to January 2023.Based on the results of coronary angiography,31 patients with only 1 vessel lesion were classified as mild group,45 patients with 2 vessel lesions were classified as moderate group,and 45 patients with 3 vessel lesions were classified as severe group.Plasma NT-proBNP and the Gensini score of coronary lesions were compared among the three groups.The correlation between plasma NT-proBNP and the degree of coronary artery disease in AMI patients was verified by Spearman correlation coefficient.Based on the comorbidity of HF,121 AMI patients were assigned into the combined group and the non-combined group.The types of HF episodes in the combined group were recorded.Clinical data of patients in the combined group and non-combined group were compared,and multiple regression analysis was conducted to identify the risk factors for HF in AMI patients.The predictive efficacy of risk factors on the occurrence of HF in AMI patients was verified by plotting the receiver operating characteristic(ROC)curves and calculating the area under the curve(AUC).Results Plasma NT-proBNP in the severe group was significantly higher than that of moderate group and mild group([145.25±20.33]pg/mL VS[126.77±20.41]pg/mL VS[112.24±20.16]pg/mL,P<0.05).The Gensini score in the severe group was significantly higher than that of moderate group and mild group([34.41±5.21]points VS[31.22±5.17]points VS[28.44±5.31]points,P<0.05).Spearman correlation showed that NT-proBNP in AMI patients was positively correlated with the Gensini score.Multivariate regression analysis showed that heart rate(HR)≥75 beats/min,left atrial diameter(LAD)≥35 mm,and NT-proBNP>125 pg/mL were risk factors for HF in

关 键 词：急性心肌梗死 冠脉病变程度 N末端B型利钠肽原 相关性分析 心力衰竭 预测效能 

分 类 号：R541.4[医药卫生—心血管疾病]