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B型脑钠肽在评估非ST段抬高急性冠脉综合征患者预后中的价值 被引量:5

Plasma B-type Natriuretic Peptide in Patients With Non-ST Elevation Acute Coronary Syndrome
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摘要 目的:目前急性冠脉综合征中ST段抬高心肌梗死患者B型脑钠肽水平增高及意义已得到广泛的认同,但对于非ST段抬高心肌梗死(Non-ST elevation myocardial infarction,NSTEMI)和不稳定性心绞痛(Unstable angina,UA)患者B型脑钠肽的变化及差别尚不肯定。本文通过分析其规律及与近期心血管事件的关系,用于危险分层评估。方法:入选急性冠脉综合征患者138例,其中NSTEMI组69例,UA组69例,同时入选胸痛就诊但冠状动脉造影正常的患者30例作为对照组。所有患者于发病6小时从周围静脉中留取血样测定B型脑钠肽,同期测定全血肌钙蛋白I。随访3个月内主要不良心血管事件的发生率。结果:①NSTEMI组、UA组、对照组B型脑钠肽水平分别为34.9pg/ml(四分位区间为18.20pg/ml至81.85pg/ml)、13.9pg/ml(四分位区间为8.00pg/ml至26.45pg/ml)和9.4pg/ml(四分位区间为5.00pg/ml至12.6pg/ml),3组之间比较差异有统计学意义,P<0.05。NSTEMI组B型脑钠肽水平最高,并且与全血肌钙蛋白I水平呈正相关(r=0.675,P<0.001)。②随访3个月,138例中有30例患者(21.7%)发生主要不良心血管事件,发生者B型脑钠肽水平高于未发生者(31.3pg/ml vs 19.35pg/ml),P=0.001。结论:非ST段抬高急性冠脉综合征患者早期B型脑钠肽水平明显升高,并且B型脑钠肽水平与近期心血管事件的发生有一定相关性,可应用于危险分层的评估。 Objective: To evaluate B-type natriuretic peptide (BNP) levels in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and its relationship with the risk factor of major adverse cardiovascular events. Methods: 138 consecutive patients with NSTE-ACS including 69 Non-ST elevation myocardial infarction (NSTEMI) and 69 unstable angina (UA) were studied. 30 chest pain patients were enrolled as Control group and the coronary heart disease was excluded by angography. BNP concentration and troponin I (TNI) level were examined at 6 hours of onset. All patients were followed up for 3 months for major adverse cardiovascular events (MACE) including heart failure, recurrent angina peetoris, and cardiac death. Results: BNP levels were higher in NSTEMI group than UA group and Control group respectively (34. 9pg/ml vs. 13.9 pg/ ml vs. 9.4 pg/ml ,P 〈0. 001 ). There was a significant correlation between BNP and TNI in patients with NSTEMI ( r = 0. 675, P 〈0. 001 ). There were 30 (21.7%) patients suffered from MACE during the follow up period of time. BNP levels were significandy higher in MACE patients. Conclusion : BNP level was higher in the early stage in patiewts with of NSTE-ACS. BNP level might be a biochemical marker of risk factor and prognosis indicator in patients with NSTE-ACS.
出处 《中国循环杂志》 CSCD 北大核心 2009年第5期333-336,共4页 Chinese Circulation Journal
关键词 B型脑钠肽 非ST段抬高心肌梗死 不稳定性心绞痛 B-type natriuretic peptide Non-ST elevation myocardial infarction Unstable angina
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参考文献7

  • 1Ndrepepa G, Braun S, Mehilli J, et al. N-terminal pro-brain natriuretic peptide on admission in patients with acute myocardial infarction and correlation with scintigraphic infarct size, efficacy of reperfusion, and prognosis. Am J Cardiol, 2006,97 : 1151-1156.
  • 2Hirayama A, Kusuoka H, Yamamoto H, et al. Usefulness of plasma brain natriuretic Peptide concentration for predicting subsequent left ventricular remodeling after coronary angioplasty in patients with acute myocardial infarction. Am J Cardio1,2006,98:453-457.
  • 3Richards AM, Nicholls MG, Espiner EA, et al. B-type natriuretic pep- tides and ejection fraction for prognosis after myocardial infarction. Circulation, 2003,107 : 2786-2792.
  • 4Sabatine MS,Morrow DA,de Lemos JA,et al. Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia. J Am Coll Cardiol,2004,44 : 1988-1995.
  • 5Bassan R,Potsch A, Maisel A, et al. B-type natriuretic peptide: a novel early blood marker of acute myocardial infarction in patients with chest pain and no ST-segment elevation. Eur Heart J, 2005,26 : 234- 240.
  • 6de Lemos JA, Marrow DA, Bentley J H, et al. The prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes. N Engl J Med,2001,345:1014-1021.
  • 7Morrow DA, de Lemos J A, Sabatine MS, et al. Evaluation of B-type natriuretic peptide for risk assessment in unstable angia/non-ST-elevation myocardial infarction B-type natriuretic peptide and prognosis in TACTICS-TIMI 18. J Am Coil Cardiol,2003,41:1264-1272.

同被引文献45

  • 1陈忠,马根山,冯毅,严金川,罗丹.脑钠肽对早发急性心肌梗死患者近期预后的影响[J].中华急诊医学杂志,2006,15(2):164-167. 被引量:15
  • 2LI Xiang,LI Pei-jie,HE Yun-fen,ZENG Hong,LI Zi-li,ZHANG Zheng-yi,CAO Wen,YANG Lan.Effects of short-acting β-adrenergic blocker on B-type natriuretic peptide at early stage of postresuscitation in rabbits[J].Chinese Medical Journal,2006(10):864-867. 被引量:21
  • 3奚耀,钱义明,顾晓刚,吴士延,钱风华,王进,顼志兵.冠状动脉病变程度和血浆脑钠肽 超敏C反应蛋白水平相关性的研究[J].中国急救医学,2007,27(6):524-526. 被引量:27
  • 4Donald SC,Colin FLA,Michelle PK,et al.Serial bedside B-type natriuretic peptide strongly predicts prognosis in acute coronary syndrome independent of echocardiographic abnormalities[J].Am Heart J,2009,158:133-140.
  • 5Morrow DA,de Lemos JA,Sabatine MS,et al.Evaluation of B-type natriuretic peptide for risk assessment in unstable angina/non-ST-elevation myocardial infarction:B-type natriuretic peptide and prognosis in TACTICS-TIMI 18 trial[J].J Am Coll Cardiol,2003,41:1264-1272.
  • 6David A,James AM,de Michael A.et al.Prognostic value of serial B-type natriuretic peptide testing during follow-up of patients with unstable coronary artery disease[J].JAMA,2005,294(22):2866-2871.
  • 7Hasdai D,Behar S,Wallentin L,et al.A prospective survey of the characteristics,treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin;the Euro Heart Survey of Acute Coronary Syndromes[J].Eur Heart J,2002,23:1190-1201.
  • 8Sabatine MS,Morrow DA,James A,et al.Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia[J].J Am Coll Cardiol,2004,44:1988-1995.
  • 9Heeschen C,Hamm CW,Mitrovic V,et al.N-terminal pro-B-type natriuretic peptide levels for dynamic risk stratification of patients with acute coronary syndromes[J].Circulation,2004,110:3206-3212.
  • 10Morrow DA,Scirica BM,Sabatine MS,et al.B-type natriuretic peptide and the effect of ranolazine in patients with non-ST-segment elevation acute coronary syndromes.observations from the MERLIN-TIMI 36 (metabolic efficiency with ranolazine for less ischemia in non-ST elevation acute coronary-thrombolysis in myocardial infarction 36) trial[J].J Am Coll Cardiol,2010,55:1189-1196.

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