BNP、CRP与急性心肌梗死并发恶性室性心律失常的相关分析

Brain natriuretic peptid,C-reactive protein and acute myocardial infraction with ventricular tachyarrhythmias

目的：探讨急性心肌梗死（AMI）患者合并恶性室性心律失常的危险因素。方法：回顾性分析我院接受急诊冠状动脉介入（PCI）的ST段抬高心肌梗死患者322例。分为恶性室性心律失常组（A组）68例和无恶性室性心律失常组（B组）254例。通过观察比较患者的一般临床情况,进行心脏超声检查,检测生化指标、C反应蛋白（CRP）及血浆脑钠肽（BNP）。并将可能的相关因素进行Logist多因素回归分析。结果：两组患者在年龄、性别构成、高血压、陈旧心肌梗死、既往血运重建病史、基础心率、血压等方面具有可比性。但A组患者的空腹血糖、CRP及BNP水平明显高于B组患者[空腹血糖（8.83±4.81）mmol/L∶（6.02±2.25）mmol/L,P=0.012;CRP（18.24±12.19）mg/L∶（11.06±10.06）mg/L,P=0.016;BNP（446.04±146.37）pg/L∶（315.01±121.11）pg/L,P=0.009]。Logist多因素回归分析示：BNP、CRP的升高是AMI患者合并恶性室性心律失常的独立危险因素（BNP：OR=1.416,95%CI：0.921~3.012,P=0.021;CRP：OR=1.367,95%CI：1.040~4.312,P=0.015）。结论：AMI患者BNP、CRP水平的升高可能预示发生恶性室性心律失常风险的增加。

Objective：To explore the risk factors in patients with acute myocardial infarction complicated with malignant ventricular arrhythmia.Method：The study was a retrospective analysis of 322 STEMI patients received primary percutaneous coronary intervention（PPCI）in our hospital from 2010 June to 2012 December.According to malignant ventricular arrhythmia,all patients were divided into：malignant ventricular arrhythmia group（A group）,68cases;non malignant ventricular arrhythmia group（B group）,254 cases.We observed and compared the two groups patients in general clinical conditions,cardiac ultrasound examination,biochemical indicator detection,C reactive protein（CPR）and plasma brain natriuretic peptide（BNP）.Logistic multi-factors regression analysis was performed.Rusult：There were no significant difference between A group with B group in aspects：age,sex,hypertension,old myocardial infarction,previous revascularization,heart rate,blood pressure,et al.There were significant differences in aspects：fasting plasma glucose（8.83±4.81）vs（6.02±2.25）mmol/L,P=0.012;CRP（18.24±12.19）vs（11.06±10.06）mg/L,P=0.016;BNP（446.04±146.37）vs（315.01±121.11）pg/L,P=0.009）.The logistic regression analysis demonstated：BNP（OR1.416,95% CI 0.921-3.012,P=0.021）and CRP（OR1.367,95%CI 1.040-4.312,P=0.015）were independent risk factors of acute myocardial infraction patients with ventricular tachyarrhythmias.Conclusion：BNP and CRP are independent risk factors of acute myocardial infraction patients with malignant ventricular tachyarrhythmias.It may indicate malignant ventricular arrhythmia incidence increase that the level of CRP and BNP elevated in patients with acute myocardial infarction.