NT-proBNP与急性心肌梗死患者冠脉病变程度的相关性

Correlation Between NT-proBNP and Severity of Coronary Artery Disease in Patients with Acute Myocardial Infarction

目的分析急性心肌梗死患者血浆B型脑尿肽前体(NT-proBNP)水平及其与冠状动脉病变严重程度之相关性。方法选取2018年8月1日-12月31日于江苏省人民医院心血管内科住院的急性心肌梗死行急诊介入治疗的患者117例,根据患者急性期心电图表现分为急性ST段抬高型心肌梗死(STEMI)组、急性非ST段抬高型心肌梗死(NSTEMI)组。入选同期住院并行冠状动脉造影结果为阴性作为对照组的患者,共68例。收集所有患者的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白a[LP(a)]、肌钙蛋白T(cTnT)、血浆B型脑尿肽前体(NT-proBNP)、左心室射血分数(EF)值、Gensini评分,分析NT-proBNP与Gensini评分之相关性。结果三组年龄、高血压占比、TC、LDL-C水平比较,差异无统计学意义(P>0.05);STEMI组与NSTEMI组的男性占比高于对照组(P<0.05);NSTEMI组糖尿病患者占比高于对照组,TG水平高于STEMI组(P<0.05);STEMI组的LDL-C、LP(a)水平高于对照组(P<0.05);STEMI组和NSTEMI组NT-proBNP及cTNT水平高于对照组,EF值低于对照组(P<0.05);NSTEMI组EF值高于STEMI组(P<0.05);STEMI组评分总分为(82.91±35.01)分,NSTEMI组评分为(75.43±42.53)分,均高于对照组的(3.65±3.91)分,差异有统计学意义(P<0.05);血浆NT-proBNP水平与Gensini评分总分值呈正相关(r=0.565,P<0.05)。结论NT-proBNP水平与急性心肌梗死患者的冠脉病变的严重程度呈正相关。

Objective To analyze the plasma B-type brain urine peptide precursor(NT-proBNP)level in patients with acute myocardial infarction and its correlation with the severity of coronary artery disease.Methods A total of 117 patients with acute myocardial infarction who underwent emergency interventional therapy in the Department of Cardiovascular Medicine of Jiangsu Provincial People's Hospital from August 1 to December 31,2018 were selected and divided into acute ST-segment elevation myocardial infarction(STEMI)group and acute non-ST-segment elevation myocardial infarction(NSTEMI)group according to their acute ECG manifestations.A total of 68 patients with negative coronary angiography results were enrolled as control group.Total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),lipoprotein a[LP(a)],troponin T(cTnT),plasma B-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(EF)and Gensini score were collected in all patients,and the correlation between NT-proBNP and Gensini score was analyzed.Results There was no significant difference in age,hypertension proportion,TC and LDL-C levels among the three groups(P>0.05).Male proportion in STEMI group and NSTEMI group was higher than that in control group(P<0.05).The proportion of diabetic patients in the NSTEMI group was higher than that in the control group,and the TG level was higher than that in the STEMI group(P<0.05).The levels of LDL-C and LP(a)in STEMI group were higher than those in the control group(P<0.05).NT-proBNP and cTNT levels in STEMI group and NSTEMI group were higher than those in control group,and EF value was lower than that in control group(P<0.05).EF value of NSTEMI group was higher than that of STEMI group(P<0.05);the total score of STEMI group was(82.91±35.01)scores,and the score of NSTEMI group was(75.43±42.53)scores,which was higher than that of the control group(3.65±3.91)scores,the difference was statistically significant(P<0.05).The plasma NT-proBNP level was positively correlated with the total Gensini score(r=0.565,P<0.01).Conclusion NT-proBNP level is positively correlated with the severity of coronary lesions in patients with acute myocardial infarction.