有关血尿素氮评价急性冠脉综合征预后的临床研究

Evaluation of prognosis of acute coronary syndrome by blood urea nitrogen

目的:探讨血尿素氮(BUN)水平变化对急性冠脉综合征(ACS)预后的影响。方法:选择上海长海医院2000年1月至2005年12月期间住院ACS患者590例,随访4年,了解与患者预后相关的主要不良心血管事件(MACE),如心绞痛、心肌梗死、脑卒中、心衰、死亡等发生情况。按入院时检验的BUN水平分为BUN<20mg/dl组(385例)、BUN20～25mg/dl组(114例)和BUN>25mg/dl(91例),比较不同水平的BUN对ACS预后的影响。结果:与BUN<20mg/dl组及BUN20～25mg/dl组相比,BUN>25mg/dl组心绞痛(50.65%比69.30%比83.75%)、心肌梗死(3.12%比6.14%比21.98%)、心衰(37.40%比50.0%比78.02%)、脑卒中(5.97%比11.40%比25.27%)、死亡(4.41%比8.77%比17.58%)发生率明显升高(P<0.05～0.001)。结论:血尿素氮变化水平与急性冠脉综合征预后相关,随着血尿素氮水平升高,急性冠脉综合征危险性增加,预后越差。

Objective：To investigate the effect of blood urea nitrogen（BUN） evaluating prognosis of acute coronary syndrome（ACS）.Methods：A total of 590 ACS inpatients（Jan,2000～ Dec,2005） from Shanghai Changhai hospital were enrolled and followed up for four years.Major adverse cardiovascular events were recorded,including angina pectoris,myocardial infarction,stroke,heart failure and death.According to levels of BUN at admission,the patients were divided into BUN〉20mg/dl group（n=385）,BUN 20～25mg/dl group（n=114） and BUN25mg/dl group（n=91）.Effects of different levels of BUN on prognosis of ACS were compared and analyzed.Results：Compared with BUN〈20mg/dl group and BUN 20～25mg/dl group,incidence rates of angina pectoris（50.65% vs.69.30% vs.83.75%）,myocardial infarction（3.12% vs.6.14% vs.21.98%）,heart failure（37.40% vs.50.0% vs.78.02%）,stroke（5.97% vs.11.40% vs.25.27%） and death（4.41% vs.8.77% vs.17.58%） significantly increased in BUN〉25mg/dl group,P〈0.05～0.001.Conclusion：Change of level of blood urea nitrogen is significantly correlated with acute coronary syndrome.As level of blood urea nitrogen increases,risk of acute coronary syndrome increases and the prognosis gets worse.