NT-proBNP与急诊PCI术中无复流的相关性研究

The Correlation between NT-proBNP and No-reflow in Patients Undergoing Emergent Percutaneous Coronary Intervention

目的:研究血浆N末端脑钠肽原(NT-proBNP)与急诊经皮冠状动脉介入治疗(PCI)术中无复流现象的相关性。方法:选择2014年1月-2015年12月笔者所在医院急救中心住院治疗的急性心肌梗死患者200例,年龄40~78岁,符合纳入条件者共132例,平均年龄63.7岁。所有患者术前均服用阿司匹林、氯吡咯雷负荷量。均在症状发生12 h内行PCI,处理血管均无残余狭窄。冠脉造影术前抽取静脉血,立即行NTproBNP、白介素(IL-6)数值检测。根据冠脉造影术中TIMI血流分级分为无复流组和血流正常组,术后TIMI血流0~2级患者为无复流组,TIMI血流3级患者为血流正常组。比较两组间术前NT-proBNP、IL-6数值有无统计学差异。用Logistic回归分析评价NT-proBNP对记性心肌梗死(AMI)患者急诊PCI术中无复流的预测价值。结果:无复流组NT-proBNP水平明显高于血流正常组(P<0.01)。无复流组IL-6明显高于血流正常组(P<0.01)。入院NT-proBNP>1247.50 ng/L是急性心肌梗死患者急诊PCI术中无复流的独立危险因素,其敏感性90.0%,特异性79.5%。结论:急性心肌梗死患者急诊PCI术中无复流发生率与NT-proBNP、IL-6水平呈正相关。

Objective： To study the correlation between NT-proBNP and the no-reflow phenomenon in the emergency percutaneous coronary intervention（PCI）.Method： NT-proBNP and IL-6 were obtained from 200 hospitalized patients with acute myocardial infarction from January 2014 to December 2015 in our emergency center, age between 40 and 78 years old.A total of 132 patients met the inclusion conditions with an average age of 63.7 years.All patients took Aspirin and Clopidogrel loading dose before treatment, and adept PCI within 12 hours occuring acute myocardial infarction（AMI） symptoms, with the coronary arteries no residual stenosis after PCI.Took 2 ml venous blood before PCI and detected NT-proBNP, interleukin-6（IL-6） immediately.According to coronary angiography TIMI flow classification the patients were divided into no-reflow group and normal blood flow group, patients with postoperative TIMI flow 0-2 levels as no-reflow group, TIMI flow grade 3 patients as normal blood flow group.The differences between the two groups of NT-proBNP, IL-6 were compared using t-test.To evaluate the predictive value of NT-proBNP in no-reflow phenomenon within emergency PCI using Logistic regression analysis.Result： The NT-proBNP level of no-reflow group was obviously higher than that of normal blood flow group（P〈0.01）.The IL-6 level of no-reflow group was obviously higher than that of normal blood flow group（P〈0.01）.NT-proBNP〉1247.50ng/Lwastheindependentriskfactorforno-reflowinthepatientswithAMIinemergencyPCI, with the sensitivity 90.0% , specificity of 79.5%.Conclusion： No-reflow is positively correlated with NT-proBNP level and IL-6 level in the emergency PCI in patients with AMI.