血清NT-proBNP检测对急性心肌梗死患者心室重构的预测价值

Predictive value of serum NT-proBNP in detection of ventricular remodeling of patients with acute myocardial infarction

目的探讨血清N末端脑钠素原(NT-proBNP)检测对急性心肌梗死(AMI)患者心室重构的预测价值。方法采用酶联免疫吸附法检测67例急性心肌梗死患者发生AMI后1、2、3、4、5、6 d和7 d血清NT-proBNP表达水平,并根据两次左心室舒张末容积指数差值将患者分为重构组和非重构组,比较两组NT-proBNP水平。根据NT-proBNP表达水平将患者分为低水平组和高水平组,比较两组心室重构的关系。结果重构组各时间点血清NT-proBNP表达水平明显高于非重构组(P<0.05);血清NT-proBNP高水平组与低水平组比较,左心功能指标LVEF值明显下降(P<0.05),左室重构指标LEDV和LESV值均明显升高(P<0.05),低水平组左室重构总发生率(23.3%,7/30)明显低于高水平组(62.2%,23/37)(P<0.05);AMI患者起病后血清NT-proBNP表达水平与LEDV和LESV值呈正相关性关系(P<0.05),与LVEF值呈负相关性关系(P<0.05)。结论血清NT-proBNP是反映AMI患者心室重构和心脏功能状态的敏感性预测指标。

[Objective] To investigate the predictive value of serum N terminal brain natriuretic peptide （NT- proBNP） in detection of ventricular remodeling of patients with acute myocardial infarction （AMI）. [Methods ] The expression level of serum NT-proBNP in 67 patients with acute myocardial infarction were detected by enzyme- linked immunosorbent assay 1, 2, 3, 4, 5, 6 d and 7 d occurred after AMI, and all patients were divided into remodehng group and non-remodeling group according to the difference of left ventricular end diastolic volume index, compared the expression level of serum NT-proBNP in two groups. All patients were divided into low level group and high level group according to the expression levels of NT-proBNP, compared the relationship of ventricular remodeling in two groups. [Results] The expression level of serum NT-proBNP in remodeling group at each time point was significantly higher than that of non-remodeling group （P 〈0.05）. Compared with the low group, left heart function index LVEF value in serum NT-proBNP high level group decreased significantly （P 〈0.05）, left ventricular remodeling index LEDV and LESV values increased significantly （P 〈0.05）, the total incidence of left ventricular remodeling in low level group （23.3%, 7/30） was significantly lower than that of the high level group（62.2%, 23/37）（P 〈 0.05）. The expression level of serum NT-proBNP in AMI patients had a positive correlation relationship with LEDV and LESV values （P 〈0.05）, and had a negative correlation relationship with LVEF value （P 〈0.05）. [ Conclusions ]The expression level of serum NT-proBNP was a sensitivity prediction index, which could reflect the state of ventricular remodeling and cardiac function in patients with AMI.