血清NT-proBNP检测对AMI患者预后和死亡风险评估的意义

Evaluative Significance of Serum NT-proBNP Determation for Prognosis and Death Risk in Patients with Acute Myocardial Infarction

目的:评估氨基末端B型钠尿肽原(NT-proBNP)浓度变化对急性心肌梗死(AMI)患者预后和死亡风险评估的意义。方法:采用双向侧流免疫法检测84例AMI患者、40名健康对照者以及AMI患者治疗后第3d、第7d血清NT-proBNP水平。所有患者平均随访180 d,观察随访期间发生的主要不良心脏事件(MACE)。结果:AMI组患者入院时血清NT-proBNP水平较健康对照组明显升高(P<0.01);且随着NT-proBNP水平增高,MACE发生率增多,NT-proBNP>2376.23 ng/L组患者随访期内出现MACE的例数明显高于NT-proBNP≤2376.23 ng/L组(P<0.01);治疗前、后NT-proBNP水平与患者随访期间MACE发生率密切相关,治疗前,≤30d死亡组血清NT-proBNP水平明显高于其他两组(P<0.05);治疗后第3d,≤30d死亡组NT-proBNP水平高于治疗前及其他两组(P<0.05),治疗后第7d,非死亡组血清NT-proBNP水平低于治疗前及治疗后第3d,亦低于2个死亡组(P<0.01);31d～180 d死亡组治疗前、后血清NT-proBNP水平差异无统计学意义(P>0.05)。结论:血清NT-proBNP水平与AMI患者预后和死亡风险密切相关,观察AMI患者早期血清NT-proBNP水平及其在治疗过程中的动态变化对AMI患者预后和死亡风险评估有重要价值。

Objective To assess the significance of serum N-terminal pro-B-type natriuretic peptide（NT-proBNP）level for prog- nosis and death risk in patients with acute myocardial infarction （AMI）. Methods The serum NT-proBNP level of 84 patients with AMI,40 healthy controls and the patients with AMI treated on the 3rd and 7th day was measured by bi-directional lateral flow immuno- assay. The main adverse cardiovascular events（MACE） were followed up for 180d. Results The serum NT-proBNP level in the AMI group was significantly higher than the control group（P 〈 O. 01 ）. Followed the higher level of the rate of MACE showed higher accord- ingly. The cases of MACE during the follow-up period in AMI patients with NT-proBNP 〉 2376.23ng/L expressed prominently higher than that with NT-proBNP 〈 2 376.23 ng/L（P 〈 0.01 ） ; The level of serum NT-proBNP before and after treatment are closely related for the rate of MACE during the follow-up period in AMI patients, before the treatment, serum NT-proBNP level in patients with the deadly group in ≤30d indicated markedly higher than that of others（P 〈 0.01 ）, on the 3rd day of posttreatment, the serum NT-proBNP level in patients with the deadly group in≤30d was significantly higher than that before treatment and higher than that of others（ P 〈 0.05 ）, on the 7rd day after treatment, the serum NT-proBNP level in patients with non-deadly group was apparently lower than that be- fore treatment,the 3rd day of posttreatment and two deadly group（P 〈 0.01 ） ;The serum NT-proBNP level of the deadly group in 31- 180 d before and after therapy manifested no significant difference（P 〉 0.05）. Conclusion The serum NT-proBNP are closely corre- lated with prognosis and death risk in patients with AMI. Observing the early serum NT-proBNP and the change of serum NT-proBNP level in the course of treatment possess important significance in the prognosis and evaluation of death risk.