血浆纤维蛋白原与脑钠素在急性心肌梗死危险度评价中的研究

Study of plasma fibrinogen and brain natriuretic peptide in risk assessment of acute myocardial infarction

目的探究血浆纤维蛋白原(Fbg)和脑钠素(BNP)水平对急性心肌梗死(AMI)危险度的评价及与其之间的相互作用。方法以2016年10月至2017年10月该院心内科住院患者104例为研究对象,其中诊断为AMI患者为AMI组(n=64),其余为非AMI组(n=40),AMI组患者随访6个月,再根据是否发生不良事件分为事件组和对照组。采用化学发光法测定血浆中BNP水平;采用凝固法检测Fbg水平。分析血浆Fbg和BNP对AMI危险度的评价及与其之间的相互作用。结果 AMI组血浆Fbg、BNP水平高于非AMI组,差异有统计学意义(P<0.05)。随冠状动脉危险程度逐渐加重,血浆Fbg与BNP水平均呈上升趋势,且冠状动脉病变严重程度与Fbg、BNP水平呈正相关(r=0.728,P<0.001;r=0.824,P<0.001)。6个月后随访AMI患者,事件组血浆Fbg、BNP水平高于对照组(P<0.05),事件组心力衰竭血浆Fbg、BNP水平高于对照组,差异有统计学意义(P<0.05)。Fbg诊断灵敏度为87.50%,特异度为62.50%,曲线下面积(AUC)为0.783;BNP诊断灵敏度为85.00%,特异度为54.68%,AUC为0.700;Fbg、BNP联合检测其诊断灵敏度为76.56%,特异度为80.00%,AUC为0.845。结论血浆Fbg、BNP水平能较好地反映患者心肌受损情况,预测病危程度与预后效果,有效指导AMI患者治疗方法的选择和改善患者预后评价。

Objective To investigate the risk assessment of acute myocardial infarction(AMI)by plasma fibrinogen(Fbg)and brain natriuretic peptide(BNP)levels and their interaction.Methods From October 2016 to October 2017,104 inpatients in the Department of Cardiology of our hospital were studied.The patients with AMI were diagnosed as AMI group(n=64)and the others as non-AMI group(n=40).The AMI patients were followed up for 6 months and then divided into event group and control group according to whether adverse events occurred.The levels of BNP in plasma were determined by chemiluminescence method and Fbg by coagulation method.The risk of AMI and the interaction between Fbg and BNP were analyzed.Results The levels of Fbg and BNP in plasma of AMI group were higher than those of non-AMI group(P<0.05).With the increasing risk of coronary artery,the levels of plasma Fbg and BNP increased,and the severity of coronary artery disease was positively correlated with the levels of Fbg and BNP(r=0.728,P<0.001;r=0.824,P<0.001).After 6 months′ follow-up,the levels of plasma Fbg and BNP in the event group were higher than those in the control group(P<0.05),and the levels of plasma Fbg and BNP in the event group were higher than those in the control group(P<0.05).The diagnostic sensitivity,specificity and AUC of Fbg were 87.50%,62.50%,0.783 respectively.The diagnostic sensitivity,specificity and AUC of BNP were 85.00%,54.68% and 0.700 respectively.The diagnostic sensitivity,specificity and AUC of Fbg and BNP were 76.56%,80.00% and 0.845% respectively.Conclusion The levels of plasma Fbg and BNP can better reflect the myocardial damage,predict the severity and prognostic effect,and effectively improve the choice of treatment methods and prognostic evaluation of patients with AMI.