急性心肌梗死患者BNP水平与无复流及冠脉病变严重程度的相关性

Correlation among BNP level,no-reflow and severity of coronary artery disease in patients with acute myocardial infarction

目的:研究急性心肌梗死(AMI)患者脑利钠肽(BNP)水平与无复流及冠脉病变严重程度的相关性。方法:入选行经皮冠状动脉介入(PCI)治疗的AMI患者120例,术中出现无复流的患者为无复流组(40例),未出现无复流的AMI患者80例作为对照组。无复流组又根据冠状动脉造影结果分为单支病变组(14例)、双支病变组(10例)、三支病变组(16例)。对上述患者血浆BNP水平进行测定比较。结果:无复流组PCI术前血浆BNP水平高于对照组[(121.8±31.2)pg/ml比(92.4±29.3)pg/ml,P=0.001]。无复流组血浆BNP的受检者工作特征曲线(ROC)下面积为0.699,表明血浆BNP水平与AMI患者PCI术后无复流具有良好的相关性。Gensini积分、BNP水平随病变支数的增加呈明显上升趋势(P<0.01),且Pearson相关分析显示,BNP水平与Gensini积分呈显著正相关(r=0.343,P=0.036)。结论:急性心肌梗死患者血浆脑利钠肽水平可为急性心肌梗死早期危险分层提供证据,并且能够较好地预测无复流的发生。

Objective：To study the correlation among no-reflow,severity of coronary artery disease and brain natriuretic peptide（BNP）levels in patients with acute myocardial infarction（AMI）.Methods：A total of 120 AMI patients undergoing percutaneous coronary intervention（PCI）were selected.According to presence of no-reflow during PCI or not,patients were divided into no-reflow group（n=40）and control group（n=80,no-reflow didn＇t occur）.According to results of coronary angiography,no-reflow group was further divided into single vessel coronary disease group（n=14,single vessel group）,double-vessel coronary disease group（n=10,double-vessel group）and triple-vessel coronary disease group（n=16,triple-vessel group）.Plasma BNP level was measured and compared among all groups.Results：Compared with control group before PCI,there was significant rise in plasma BNP level[（92.4±29.3）pg/ml vs.（121.8±31.2）pg/ml,P=0.001]in no-reflow group.For plasma BNP level of no-reflow group,its area under receiver operating characteristic curve（ROC）was 0.699,suggesting that plasma BNP level was significantly correlated with no-reflow after PCI in AMI patients.Gensini score and BNP level significantly rose along with number of diseased vessels increases（P〈0.01）,and Pearson correlation analysis indicated that BNP level was significant positively correlated with Gensini score（r=0.343,P=0.036）.Conclusion：Plasma BNP level in AMI patients can provide favorable evidence for early risk stratification of AMI,and predict occurrence of no-reflow well.