急性ST段抬高型心肌梗死合并恶性室性心律失常患者血浆NT-proBNP、TC水平的变化及临床意义

Changes and clinical significance of plasma NT-proBNP and TC levels in patients with acute ST-segmentelevation myocardial infarction complicated with malignant ventricular arrhythmia

目的探讨急性ST段抬高型心肌梗死(STEMI)合并恶性室性心律失常(MVA)患者血浆N-末端脑钠肽前体(NT-proBNP)、总胆固醇(TC)水平的变化及临床意义,为患者的临床诊疗提供指导。方法选取2018年1月至2020年1月陕西中医药大学附属医院以及陕西中医药大学第二附属医院接收诊治的164例STEMI患者为研究对象,根据其是否合并MVA,将所有患者分为对照组(未合并MVA,129例)和研究组(合并MVA,35例)。检测并比较两组患者的血浆NT-proBNP、TC水平,分析NT-proBNP、TC单独检测及两者联合检测对STEMI患者是否合并MVA的预测价值,并采用Pearson相关性分析患者血浆NT-proBNP与TC的相关性。结果研究组患者的血浆NT-proBNP、TC水平分别为(1831.72±182.65)pg/mL、(5.32±0.84)mmol/L,明显高于对照组的(1016.52±102.12)pg/mL、(4.00±0.57)mmol/L,差异均有统计学意义(P<0.05);两者联合检测的灵敏度、特异度及准确度(94.51%、98.78%、98.17%)明显高于血浆NT-proBNP(83.54%、92.68%、90.85%)和TC(77.44%、90.24%、88.41%)的单独检测,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,患者血浆NT-proBNP水平与TC水平呈正相关(r=0.675,P<0.05)。结论STEMI合并MVA患者血浆NT-proBNP、TC水平较高,两者联合检测可以有效提高预测患者是否合并MVA的灵敏度、特异度和准确度,且两者之间呈正相关关系,临床检测血浆NT-proBNP、TC水平对患者病情诊断、早期预警及干预有重要意义。

Objective To investigate the changes and clinical significance of plasma N-terminal brain natriuretic peptide precursor(NT-proBNP)and total cholesterol(TC)levels in patients with acute ST segment elevation myocardial infarction(STEMI)and malignant ventricular arrhythmia(MVA),and to provide relevant guidance for clinical diagnosis and treatment.Methods A total of 164 STEMI patients,who admitted to the Affiliated Hospital of Shaanxi University of Chinese Medicine and the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2018 to January 2020,were selected as study subjects.According to whether they had MVA or not,all the patients were divided into the control group(without MVA,129 cases)and study group(with MVA,35 cases).The plasma NT-proBNP and TC levels of the two groups were detected and compared,the predictive value of NT-proBNP,TC alone,and combined detection for STEMI patients with MVA were analyzed,and Pearson correlation was used to analyze the correlation between plasma NT-proBNP and TC in the patients.Results The plasma NT-proBNP and TC levels of patients in the study group were(1831.72±182.65)pg/mL and(5.32±0.84)mmol/L,which were significantly higher than corresponding(1016.52±102.12)pg/mL and(4.00±0.57)mmol/L in the control group(P<0.05);the sensitivity,specificity,and accuracy of the combined test(94.51%,98.78%,and 98.17%)were significantly higher than those of independent detection by plasma NT-proBNP(83.54%,92.68%,90.85%)and TC(77.44%,90.24%,88.41%),all P<0.05;Pearson correlation analysis showed that the patient's plasma NT-proBNP level was positively correlated with TC level(r=0.675,P<0.05).Conclusion The plasma levels of NT-proBNP and TC of STEMI patients with MVA are relatively high,and the combined detection of the two can effectively improve the sensitivity,specificity,and accuracy of predicting whether patients are combined with MVA,and the two are positively correlated.Clinical detection of plasma NT-probNP,TC level is of great significance to the disease diagnosis,early warning and intervention of patients.