BNP、AngⅡ及CRP在急性冠状动脉综合征患者PCI预后不良中的预测价值

Predictive Value of BNP,AngⅡand CRP in Poor Prognosis of PCI in Patients With Acute Coronary Syndrome

目的探究血清脑钠肽(brain natriuretic peptide,BNP)、血管生成素Ⅱ(angiopoietin-Ⅱ,AngⅡ)及C反应蛋白(C-reactive protein,CRP)水平在急性冠状动脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入术(percuta neouscoronaryintervention,PCI)预后不良中的预测效果。方法选取2018年12月—2020年12月厦门医学院附属第二医院收治的82例ACS患者以及80例健康体检者作为研究对象,前者为ACS组,后者为健康组。对比两组的BNP、AngⅡ、CRP水平。对ACS组患者随访2年,统计不良心血管事件的发生率;分析ACS经PCI治疗预后不良的独立危险因素;对比BNP、AngⅡ、CRP及三者联合检测对ACS患者PCI预后不良的预测效果。结果ACS组患者的BNP、AngⅡ、CRP水平均明显高于健康组(P<0.05)。随访2年,82例ACS患者有29例发生MACE,53例未发生MACE,不良预后组≥60岁患者的比例以及BNP、AngⅡ、CRP水平均高于预后良好组(P<0.05)。BNP、AngⅡ、CRP水平偏离正常值是ACS患者PCI预后不良的独立危险因素(P<0.001)。ROC曲线显示BNP、AngⅡ、CRP与三者联用检测的面积分别为0.841、0.072、0.943、1.000。结论BNP、AngⅡ、CRP水平偏离正常数值是ACS患者PCI预后不良的独立危险因素,临床可通过BNP、AngⅡ、CRP的联合检测来预测ACS患者PCI预后不良的风险。

Objective To explore the predictive effect of serum brain natriuretic peptide(BNP),angiopoietin-Ⅱ(AngⅡ)and C-reactive protein(CRP)levels in patients with acute coronary syndrome(ACS)in poor prognosis of percutaneous coronary intervention(PCI).Methods From December 2018 to December 2020,a total of 82 patients with ACS admitted to the Second Affiliated Hospital of Xiamen Medical College and 80 healthy persons were selected as the observation objects,the former being ACS group and the latter being health group.The levels of BNP,AngⅡand CRP were compared between ACS patients and healthy people.Patients in ACS group were followed up for 2 years,and the number of adverse cardiovascular events was counted;To analyze the independent risk factors of poor prognosis of ACS after PCI;To compare the predictive effect of BNP,AngⅡ,CRP and their combined detection on the poor prognosis of PCI in ACS patients.Results The levels of BNP,AngⅡand CRP in ACS group were significantly higher than those in healthy group(P<0.05).During a 2-year follow-up,29 of 82 ACS patients had MACE,while 53 had no MACE.The proportion of patients≥60 years old in the poor prognosis group and the levels of BNP,AngⅡ,CRP were higher than those in the good prognosis group(P<0.05).The deviation of BNP,AngⅡand CRP levels from normal values was an independent risk factor for poor PCI prognosis in ACS patients(P<0.001).The ROC curve showed that the areas of BNP,AngⅡ,CRP and their combined detection were 0.841,0.072,0.943 and 1.000 respectively.Conclusion The deviation of BNP,AngⅡand CRP levels from normal values is an independent risk factor for poor PCI prognosis in ACS patients.The risk of poor PCI prognosis in ACS patients can be predicted by the combined detection of BNP,AngⅡand CRP.