血浆NT-proBNP预测急性非ST段抬高心肌梗死患者血管急性闭塞和心源性死亡的价值

Prediction of Acute Vascular Occlusion and Cardiac Death in Patients with NSTEMI by Serum NT-pro BNP

目的:探讨N端脑钠肽前体(NT-pro BNP)预测急性非ST段抬高心肌梗死(NSTEMI)患者急性血管闭塞和心源性死亡的作用。方法:51例NSTEMI患者分为冠脉闭塞组和冠脉非闭塞组,2组患者行常规心脏B超检查,血清心肌肌钙蛋白I(c Tn I)和NT-pro BNP检测;观察2组患者12个月内心源性死亡的发生情况,分析NT-pro BNP、c Tn I和左心室射血分数(LVEF)预测血管急性闭塞和心源性死亡的准确度及与预后有关的因素。结果:冠脉闭塞组患者血浆NT-pro BNP和c Tn I均高于冠脉非闭塞组(P<0.01),2组患者二维B超结果比较,差异无统计学意义(P>0.05);血浆NT-pro BNP预测NSTEMI患者发生血管急性闭塞的准确度接近c Tn I,而高于LVEF;NT-pro BNP预测NSTEMI患者发生心源性死亡的准确度明显高于c Tn I和LVEF;NT-pro BNP、c Tn I及LVEF是NSTEMI患者发生心源性死亡的独立危险因子,相对危险度分别为1.000,0.968和0.979。结论:血浆NT-pro BNP预测NSTEMI患者发生血管急性闭塞和心源性死亡的准确度较高。

Objective： To investigate the function of N-terminal brain natriuretic peptide（ NT-pro BNP） to predict acute vascular occlusion and cardiac death in patients with acute non-ST segment elevation myocardial infarction（ NSTEMI）. Methods： Fifty-one NSTEMI patients were divided into coronary artery occlusion group and coronary artery non-occlusion group. All patients underwent routine cardiac B-ultrasound test,cardiac troponin I（ c Tn I） and NT-pro BNP testing; the occurrence of cardiac death of two groups was observed for 12 months. Analyzing c Tn I,NT-pro BNP and LVEF accuracy in predicting acute vascular occlusion and cardiac death and observing prognosis relevant factors. Results： c Tn I and NT-pro BNP values of plasma of coronary artery occlusion group were much higher than the non-occlusion group（ P〈0. 01）,comparison of B-ultrasound test results showed no statistical significance（ P〉0. 05）; accuracy of plasma NT-pro BNP in predicting acute vascular occlusion was close to c Tn I but higher than LVEF; accuracy of NT-pro BNP in predicting cardiac death was significantly higher than c Tn I and LVEF. NT-pro BNP,c Tn I and LVEF were the independent risk factors of cardiac death for NSTEMI patients,relative risk were 1. 000,0. 968 and 0. 979. Conclusion： The accuracy of plasma NT-pro BNP in prediction of NSTEMI patients with vascular occlusion and cardiac death is higher.