血浆尿素氮水平对急性ST段抬高型心肌梗塞患者死亡率的预测作用

The Predicting Value of the Level of BUN for the Long Term Mortality of the STEMI Patients

目的:肾功能不全在急性冠脉综合症及其它心血管疾病中通常伴随着较高的死亡率。而血浆尿素氮是反映血液动力学改变及肾脏灌注改变的非常敏感的指标。本试验研究血浆尿素氮水平的高低对于急性ST段抬高型心肌梗塞患者死亡率的预测作用。方法:研究300名患急性ST段抬高型心肌梗塞患者长程的死亡率与入院时血浆尿素氮水平及住院时血浆尿素氮水平升高之间的关系。结果:在平均随访27个月,56(18.5%)个患者死亡。使用生存分析对于血浆尿素氮水平升高与血浆尿素氮水平正常两组患者进行研究,用log-rank检验将两组数据进行比较,有明显统计学意义,P<0.001。结论:对于患急性ST段抬高型心肌梗塞患者的长期死亡率,入院时的血浆尿素氮水平是一个独立的预测因素。BUN和BUN/creatinine比值的增高也能对患急性ST段抬高型心肌梗塞患者的长期死亡率提供一定的预测信息。同时,住院期间的BUN增高对于患急性ST段抬高型心肌梗塞患者的长期死亡率也能够提供额外的预测信息。

Objective：The mortality of the patients with renal dysfunction accompanied with acute coronary syndrome and other cardiovascular diseases is usually high in the clinical practice.Blood urine nitrogen（BUN） is a very sensitive index which evaluates the hemodynamic change and the renal perfusion state.This trial＇s aim is to do some research on the level of the BUN which can provide the predicting value for the mortality of the acute ST-segment elevation myocardial infarction（STEMI）.Methods：Three hundred cases with acute ST-segment elevation myocardial infarction are enrolled in this trial.Regular follow up of the level of the BUN on admission and during hospital and find the relationship between the mortality and the BUN level.Results：During the mean 27 months periods of follow up,56（18,5%） patients died.All the patients are divided into two groups.The patients with elevated BUN are enrolled into experimental group and the other patients with normal BUN are enrolled into control group.Then use the survival analysis to evaluate the different outcome of the two groups.The data are compared by the method of log-rank test and there is significant difference,P〈0.001.Conclusion：For the long term mortality of the STEMI patients,the level of BUN on admission is an independent predicting factor.And the increasing level of the BUN and the BUN/creatinine can also provide some predicting information for the mortality of the STEMI patients.At the same time,the increasing level of the BUN during hospital can provide additional predicting information for the STEMI patients＇ long term mortality.