氨基末端脑钠肽前体对老年非ST段抬高型急性冠脉综合征患者病变程度的预测作用

The value of NT-probrain natriuretic peptide in predicting the severity of the coronary lesions in old patients with non-ST elevation acute coronary syndromes

目的评价氨基末端脑钠肽前体（NT—proBNP）和老年患者冠状动脉病变程度以及年龄的关系。方法检测258例老年非ST段抬高型急性冠脉综合征（NST—ACS）患者单支病变组97例、2支病变组89例、3支／a!主干病变组72例和62例对照组的NT-proBNP水平，比较不同病变组和不同年龄段患者NT—proBNP水平。结果单支病变组、2支病变组、3支／左主干病变组及对照组NT-proBNP水平分别为（197．3±80．2）ng／L、（381．7±73．5）ng／L、（496．5±99．8）ng／L和（68．2±36．1）ng／L，各病变组均较对照组显著升高，2支、3支／左主干病变组NT—proBNP水平高于单支病变组，3支／左主干病变组NT—proBNP水平高于2支病变组，其冠状动脉病变程度越重NTproBNP水平越高（均P〈0．01）；60岁～、70岁～、≥80岁病变组患者NT—proBNP水平分别为（182．3±69．1）ng／L、（302．7±87．5）ng／L和（482．1±82．2）ng／L，年龄越大NT—proBNP水平越高（均P〈0．01）。结论老年患者年龄越大NT—proBNP水平越高，其冠状动脉病变程度越重；且NT—proBNP水平对指导NST—ACS患者的临床治疗具有极大的意义。

Objective To evaluate the relationship between NT-probrain natriuretic peptide （NT-proBNP） levels and the degree of coronary artery stenosis in elderly patients with non-ST elevation acute coronary syndromes （NST-ACS） . Methods The levels of NT-proBNP were determined in 258 elderly patients with NST-ACS divided into 3 quartile groups based on the degree of coronary artery stenosis, and 62 normal controls. And NT-pro BNP were compared among 4 groups. Results The serum levels of NT-proBNP were increased in the NST-ACS patients with single, two or three-artery lesion compared with normal controls [（ 197.3 ＋ 80.2） ng/L, （381.7 ＋ 73.5 ） ng/L., （496.5＋ 99.8）ng/L vs. （68.2 ＋36.1）ng/L]. The level of NT-proBNP was enhanced along with increasing severity coronary artery disease （all P〈0.01）. And with aging, the NT-proBNP levels were rising [aged〉60-69 years： （182. 344±69.13） ng/L; aged70-79 years： （302. 68＋87.51）ng/L ; aged≥80 years ： （482. 09＋82.2）ng/L] （all P〈0.01）. Conclusions The NT-proBNP level is enhanced along with aging and increasing severity of coronary artery stenosis in elderly NST-ACS patients.