NT-proBNP与急性冠脉综合征患者冠脉病变程度及预后的关系

Correlation between NT-proBNP and Coronary Artery Disease and Prognosis in Patients with Acute Coronary Syndrome

目的:探讨N末端脑钠肽原(NT-pro BNP)与急性冠脉综合征(ACS)患者冠脉病变程度及预后的关系。方法:选择2012年1月至2015年6月我院收治的ACS患者400例为研究对象,根据病情症状的不同将患者分为不稳定心绞痛(UA)组和急性心肌梗死(AMI)组,各200例,另选同期200例非ACS患者作为对照组,比较各组患者的NT-pro BNP水平及ACS患者的心功能情况,并比较ACS患者的冠脉造影结果,通过Syntax评分系统评价冠脉病变,随访6-12个月,对比各组患者的主要心血管不良事件(MACE)发生率,通过上述比较及分析,研究ACS患者NT-pro BNP与冠脉病变程度及预后的关系。结果:AMI组及UA组患者的NT-pro BNP水平明显高于对照组,且AMI组患者的NT-pro BNP水平明显高于UA组,差异有统计学意义(P<0.05);AMI组患者的冠脉病变Syntax积分高于UA组,差异有统计学意义(P<0.05);冠脉病变Syntax积分≥33分的ACS患者的NT-pro BNP水平高于Syntax积分0-22分的患者,差异有统计学意义(P<0.05);同时双支病变和三支病变患者的Syntax积分及NT-pro BNP水平高于单支病变患者,差异有统计学意义(P<0.05);随访6-12个月发生MACE患者的NT-pro BNP水平明显高于未发生MACE者,差异有统计学意义(P<0.05)。Pearson相关性分析显示,患者的冠脉病变程度与NT-pro BNP及Syntas积分均呈正相关(r=0.667,0.842;P<0.05)。患者随访6-12个月MACE发生率与NT-pro BNP及Syntas积分也呈正相关(r=0.708,0.821;P<0.05)。结论:ACS患者的冠脉病变程度及预后与其NT-pro BNP水平具有较好的相关性,值得临床关注。

Objective： To study the correlation between N-terminal pro brain natriuretic peptide（NT-pro BNP）and acute coronary syndrome（ACS）and prognosis in patients with acute coronary syndrome. Methods： Selected 400 cases of patients with ACS who treated in our hospital from January 2012 to June 2015 as the objects,and were divided into unstable angina pectoris（UAP）group and acute myocardial infarction（AMI）group according to the different symptoms of the disease, with 200 patients in each group, and selected 200 cases of normal non ACS patients as the control group over the same period, compared the NT-pro BNP level and heart function of patients in each group, compared the results of coronary angiography in patients with ACS, and evaluation of coronary artery disease by Syntax scoring system, followed-up 6-12 months, compared the incidence rate of major cardiovascular adverse events（MACE）in each groups,through the above comparison and analysis, explore the correlation between NT-pro BNP and coronary lesion degree and prognosis in patients with ACS. Results： The NT-pro BNP levels of patients in AMI group and UA group were significantly higher than control group,and the NT-pro BNP level of patients in AMI group was higher than those in UA group, the differences were statistically significant（P〈0.05）; The Syntax coronary lesion score in AMI group were higher than those in UA group, the NT-pro BNP level of ACS patients with Syntax coronary lesion score≥33 were higher than the patients with Syntax score 0-22, the difference was statistically significant（P〈0.05）; At the same time, the Syntax scores and NT-pro BNP levels of patients with double branch lesions and three lesions were higher than that with single lesions, the differences were statistically significant（P〈0.05）; The NT-pro BNP levels of patients with MACE were significantly higher than those without MACE after followed-up of 6-12 months, the differences was statistically significant（P〈0.05）. Pearson correlation analysis showed that, the degree of coronary artery disease was positively correlated with NT-pro BNP and Syntas scores（r=0.667, 0.842; P〈0.05）, the incidence of patients who followed-up for 6-12 months with MACE was positively correlated with NT-pro BNP and Syntas scores（r=0.708, 0.821; P〈0.05）. Conclusion： The degree of coronary artery disease and prognosis of ACS patients with NT-pro BNP and Syntas points have good correlation, which is worthy of clinical attention.