NT-proBNP、Tei指数联合GRACE评分预测急诊PCI患者短期预后的价值

Predictive value of NT-proBNP, Tei index and GRACE score in short-term prognosis of patients undergoing primary percutaneous coronary intervention

目的探讨NT-pro BNP、Tei指数联合GRACE评分对急诊经皮冠脉介入（PCI）患者短期预后的预测价值。方法入选147例急性心肌梗死（AMI）并接受急诊PCI患者为研究对象,观察记录所有患者的NT-pro BNP、Tei指数和GRACE评分水平,并随访PCI术后30 d的主要不良心脏事件（MACE）。对比分析发生MACE事件（n=34）和没有发生MACE（n=113）事件患者各项指标的差异。结果 MACE组患者的GRACE评分、NT-pro BNP水平和Tei指数均显著高于非MACE组（P〈0.05）。相关分析结果显示,Tei指数和NT-pro BNP水平以及GRACE评分均呈正相关（r=0.819,P〈0.05;r=0.797,P〈0.05）;NT-pro BNP水平和GRACE评分亦呈正相关（r=0.658,P〈0.05）。多变量Logistic回归分析显示,心衰病史（P=0.009,OR=1.401,95%CI：1.076-5.814）,NT-pro BNP〉1 000 ng/ml（P=0.010,OR=1.742,95%CI：1.076-9.822）,Tei指数〉0.60（P=0.015,OR=1.826,95%CI：1.141-4.023）,GRACE评分〉140（P=0.004,OR=2.140,95%CI：1.274-11.752）是MACE事件的独立危险因素。结论 NT-pro BNP、Tei指数联合GRACE评分能更全面准确地评估急诊PCI术后的短期预后。

Objective To investigate the predictive value of NT-proBNP, Tei index and GRACE score in short-term prognosis of patients undergoing primary percutaneous coronary intervention （PCI）. Methods A total of 147 patients with acute myocardial infarction （AMI） undergoing primary PCI were enrolled in the study. The levels of NT-proBNP, Tei index and GRACE score after primary PCI were recorded. The patients were divided into MACE group （n=34） and non-MACE group （n=l 13）, according to whether MACE were documented during 30-day follow up. NT-proBNP, Tei index and GRACE score were compared between the two groups. Results Levels of NT-proB- NP, Tei index and GRACE score in MACE group were significantly higher than those in non-MACE group （P〈 0.05）. Correlation analysis indicated that Tei index was positively correlated with NT-proBNP and GRACE score （r= 0.819, P〈0.05; r=0.797, P〈0.05）. GRACE score was also positively correlated with NT-proBNP （r=0.658, P〈0.05）. Multivariate logistic regression analysis showed that heart failure （P=-0.009, OR=1.401, 95% CI 1.076-5.814）, NT-proBNP〉1 000 ng/ml （P=-0.010, OR=1.742, 95% CI 1.076-9.822）, Tei index〉0.60 （P=0.015, OR=1.826, 95% CI 1.141--4.023）, GRACE score〉140 （P=0.004, OR=2.140, 95%CI 1.274-11.752） were the independent risk factors of MACE. Conclusion Integrated application of NT-proBNP, Tei index and GRACE score may be more accurate in predictive evaluation of the short-term prognosis after primary PCI.