急性心肌梗死患者血浆N-末端脑钠钛前体、D-二聚体水平与GRACE危险评分的关系

Relationship between plasma NT-proBNP, D-dimer and GRACE risk score in patients with acute myocardial infarction

目的探讨急性心肌梗死（AMI）患者,血浆N-末端脑钠钛前体（NT-proBNP）、D-二聚体水平与GRACE危险评分的关系。方法收集2011年1月至12月,在我院心脏中心住院的AMI患者132例,入院后即刻测定血浆NT-proBNP、D-二聚体浓度,计算GRACE危险评分。同时收集120例冠脉造影结果呈阴性的对照者血浆NT-proBNP、D-二聚体指标,与AMI组进行比较。以GRACE危险评分差异分为低危（〈109分）、中危（109-140分）、高危（〉140分）3组,分析不同组别间血浆NT-proBNP、D-二聚体水平的变化。分析NT-proBNP、D-二聚体水平与GRACE危险评分的相关性。结果AMI组患者的血浆NT-proBNP、D-二聚体水平[（3190.72±6834.36）ng/l、（0.31±0.28） mg/l]均高于对照组[（104.99±64.76）ng/l、（0.12±0.06） mg/l],差异均有统计学意义（P〈0.05）。低危、中危、高危3组[NT-proBNP水平分别为（251.78±314.36）ng/l、（2132.72±5444.9）ng/l、（5870.53±8847.22） ng/l,D-聚体水平分别为（0.12±0.08）mg/l、（0.29±0.29）mg/l、（0.40±0.31）mg/l]之间NT-proBNP、D-二聚体水平比较,差异均有统计学意义（P〈0.05）。NT-proBNP、D-二聚体水平随GRACE危险评分升高而升高,呈正相关（相关系数分别为r=0.571,r=0.446,P〈0.05）。 结论血浆NT-proBNP、D-二聚体水平可帮助判断AMI的危险程度。

Objective To evaluate the relationships between Plasma NT-proBNP, D-dimer and GRACE risk scores in patients with acute myocardial infarction（AMI）.Methods 132 patients with AMI were enrolled from January to December 2011 as the AMI group. Plasma NT-proBNP, D-dimer and GRACE scores were measured in the group immediately just after admission. The levels of plasma NT -proBNP and D-dimer were compared with the control group, which included 120 cases without coronary heart disease. The AMI patients were divided into low risk group（〈109）,middle risk group（109-140） and high risk group（〉140）according to CRACE risk scores. Then the differences of the levels of plasma NT-proBNP and D-dimer among groups were compared.The relationships between the levels of Plasma NT-proBNP, D-dimer and GRACE risk scores were analyzed. Result The levels of plasma NT-proBNP and D-dimer were significantly higher in the AMI group than in the control group[（3190.72±6834.36）ng/l vs.（104.99±64.76）ng/l;（0.31±0.28） mg/l vs.（0.12±0.06） mg/l,P〈0.05]. In 3 groups defined by GRACE risk stratification,the levels of plasma NT-proBNP[（251.78±314.36）ng/l、（2132.72±5444.9）ng/l、（5870.53±8847.22） ng/l] and D-dimer[（0.12±0.08）mg/l、（0.29±0.29）mg/l、（0.40±0.31）mg/l] were significantly different（（P〈0.05）.There were positive correlations between plasma NT-proBNP,D-dimer and GRACE risk scores in the AMI patients（r=0.571,r=0.446,P〈0.05）. Conclusion Plasma NT-proBNP and D-dimer can help to determine the severity of AMI.