BNP对行急诊冠状动脉介入治疗患者预后价值的应用

Prognostic Value Application of Brain Natriuretic Peptide in Patients with Acute Myocardial Infarction Treated with Priary Percutaneous Coronary Intervention

目的:观察ST段抬高的急性心肌梗死(STEAMI)患者接受急诊直接冠状动脉介入治疗(PCI)后的脑利钠肽(BNP)水平对长期预后价值的应用。方法:连续入选2009年1月～2011年1月之间,发病后12小时之内接受急诊直接PCI治疗的ST段抬高的急性心肌梗死患者184例,采用荧光免疫抗原抗体结合方法测定发病后24小时血浆BNP水平。根据BNP浓度分为3组:A组<100pg/mL,B组100～400pg/mL,C组>400pg/mL。收集住院期间的临床资料,并随访1年。结果:①冠状动脉造影结果中B组、C组多支血管病变比例明显高于A组(P<0.01)。②1年内病死率C组明显高于A、B组(P<0.01),进行多因素logistic回归分析,血浆BNP浓度是AMI后1年病死率的独立预测因子。结论:接受急诊直接冠状动脉介入治疗的ST段抬高的急性心肌梗死患者的早期血浆脑利钠肽水平可作为1年后病死率的预测因子。

Objective： To evaluate the value of brain natriu retic peptide （BNP） on predicting long-term mortahty after hospital discharge in patients with ST elevated acute myocardial infarction（STEAMI） treated with primary percutaneous coronary in tervention （PCI） .Methods： From January 2009 to January 2011,consecutive 184 patients with STEAMI, successfully perfused by primary PCI within 12 hours were included in this study.BN P plasma concentration levels were measured by fluorescence immunoassay at 24h from onset, and patients were divided in to 3 groups： groupA （〈100pg/ml）; groupB （100 - 400pg/ml）; groupC （〉400pg/ml） .The clinical data was collected during hospitalization and all patients were followed up for 12 months. Results： （1）Compared with group A, patients in group B, C had more muir-vessel diseases （P〈0.01） . （2）There was sign ificantly higher 1- year mortality in group C compared with group A, B （ P 〈0.01）. By multivariate analysis, BNP plasma concentration was an independent predictor of long-term mortality （P〈 0.05）. Conclusions： Earlyphase BNP plasma concentrations after successful PCI in patients with ST elevated acute myocardial infarction maybe a strong predictor for 1-year mortality.