脑利钠肽与急性冠脉综合征主要不良事件的关系

Relationship between Serum Brain Natriuretic Peptide and Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome

目的探讨脑利钠肽(BNP)水平与急性冠脉综合征(ACS)患者主要心脏不良事件(MACE)(心源性死亡,再次心肌梗死,再发心绞痛,继发心衰和再入院的复合终点)发生率的关系。方法本院心内科住院资料完整的急性冠脉综合征患者98例,入院后24h内测血浆脑利钠肽水平,所有患者根据血浆脑利钠肽水平分为三组:A组BNP水平≤100ng/L,B组100ng/L<BNP水平<400ng/L,C组BNP水平≥400ng/L。所有患者均行冠脉造影,必要时行支架植入术或冠脉搭桥术(CABG),比较不同BNP水平ACS患者住院期间、出院1个月、出院3个月MACE发生率及各组患者冠脉病变情况。结果随访3个月,A组无心源性死亡和再次心肌梗死发生,B组2例出现心源性死亡,2例出现再次心肌梗死,C组2例出现心源性死亡,2例出现再次心肌梗死。且住院期间、出院1个月、3个月三组患者MACE发生率C组>B组>A组,三组之间有显著性差异。结论急性冠脉综合征患者入院时BNP水平越高,其MACE发生率越高,BNP测定对ACS患者MACE有较强的预测价值。

Objective To explore the correlation of serum brain natriuretic peptide（BNP） and the major adverse cardiac events（MACEs） in the patients with acute coronary syndrome（ ACS ）. Methods Ninty-eight patients whose data were available were enrolled in this study, serum BNP level was measured in the patients with ACS during 24 hours after admission,and the patients were divided into 3 groups based on the BNP level,Group A ：BNP level ≤ 100ng/mL; Group B： 100ng/ml〈 BNP level 〈400ng/mL; Group C：BNP level ≥400ng/mL. And the total mortality and MACEs including death,recurrent angina,heart failure and re-admission for any reason in hospitalization,were analyzed at 1 month and 3 months after hospital discharge. Results A three-month follow-up showed that no cardiac death and re-myocardial infarction happened in Group A,there were two cases of cardiac death and 2 cases of re-myocardial infarction in Group B,and two cases of cardiac death and 2 eases of re-myocardial infarction in Group C. There was a significant differenee in the occurrence of MACEs between the three groups,with a higher MACE occurrence of Group C than that of Group B and in turn,than thai of Group A（P〈0.01 ）. Conclusion The higher the BNP level in the patients with ACS is on admission,the higher the MACE occurrence may be. The determination of serum BNP level may predict the MACE occurrence rate in the patients with ACS.