血清N-末端脑钠肽水平与急性冠脉综合征严重程度的相关性

Ralationship between the level of serum N-terminal brain natriuretic peptide and the severity of acute coronary syndrome

目的 探讨血清N-末端脑钠肽（NT-proBNP）水平与急性冠脉综合征（ACS）病变严重程度及心脏不良事件发生的相关性.方法 回顾性分析2012年3月至2013年10月134例ACS患者的临床资料,将134例患者分为三组：不稳定型心绞痛（UA）组45例、非ST段抬高性急性心肌梗死（NSTEMI）组43例、ST段抬高急性心肌梗死（STEMI）组46例,采用酶联免疫吸附法（ELISA）检测NT-proBNP,分析NT-proBNP与冠状动脉病变程度的关系.结果 NSTEMI组、STEMI组患者血清NT-proBNP水平均明显高于UA组,差异有统计学意义（P＜0.05）;3支、2支病变组NT-proBNP水平明显高于1支病变组,差异有统计学意义（P＜0.05）;STEMI组患者心力衰竭发生率、心源性死亡率等心脏不良事件发生率均明显高于UA组及NSTEMI组,差异有统计学意义（P＜0.05）.结论 ACS患者血清NT-proBNP水平有助于判断冠状动脉病变程度,指导临床治疗,结合临床表现、心电图、冠脉造影等因素评估患者预后.

Objective To investigate the relationship between serum N-terminal brain natriuretic peptide（NT-proBNP）level and the severity of the acute coronary syndrome（ACS） and heart adverse event occurrence.Methods A retrospective analysis was conducted in terms of 134 patients with ACS from March 2012 to October 2013.They were divided into three goups：unstable angina（UA） group（45 cases）,non-ST elevation acute myocardial infraction （NSTEMI） group （43 cases） and ST elevation acute myocardial infraction（STEMI） group（46 cases）.NT-proBNP levels were tested with enzyme linked immunosorbent assay to analyze the correlation between the NT-proBNP and the severity of coronary artery disease.Results The NT-proBNP levels of the patients in NSTEMI group and STEMI group were apparently higher than that of UA group,there was significant difference between the two groups （P 〈 0.05）.The NTproBNP levels of the patients in 3 and 2 lesion groups were apparently higher than that of UA group.There was significant difference between the two groups （P 〈 0.05）.The incidence of heart failure,cardiogenic death rate and adverse cardiac events of the patients in STEMI group were all apparently higher than thatin UA group and NSTEMI group,there were significant differences between the two groups （P 〈 0.05）.Conclusions The serum NT-proBNP level of patient with ACS can help to assess the severity of coronary artery disease,evaluate the illness accurately and guide the clinical treatment.It can also evaluate the patients＆#39; prognosis combined with their clinical manifestation,electrocardiogram and coronary angiogram.