不稳定型心绞痛患者发生AMI的影响因素及NT-proBNP对AMI的预测价值分析

Analysis of the Influencing Factors of AMI in Patients with Unstable Angina Pectoris and the Predictive Value of NT-proBNP for AMI

目的:探讨不稳定型心绞痛(UAP)患者发生急性心肌梗死(AMI)的影响因素,以及N末端脑钠肽前体(NT-proBNP)对AMI发生风险的预测价值。方法:选择2021年2月—2023年2月上饶市人民医院收治的120例UAP患者作为研究对象。所有患者均检测NT-proBNP水平,并比较不同严重程度UAP患者NT-proBNP水平。随访1年,记录UAP患者AMI的发生情况,并根据是否发生AMI将其分为两组:发生组(n=23)和未发生组(n=97)。对发生AMI的UAP患者进行多因素logistic回归分析。绘制受试者操作特征(ROC)曲线,以曲线下面积(AUC)评估NT-proBNP对UAP患者AMI发生风险的预测效能。结果:不同严重程度UAP患者NT-proBNP对比,差异有统计学意义(P<0.05);重度组NT-proBNP高于轻度组和中度组,中度组NT-proBNP高于轻度组,差异均有统计学意义(P<0.05)。120例UAP患者中有23例(19.17%)发生AMI。发生组重度UAP占比、NT-proBNP均高于未发生组,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,重度UAP[OR=3.550,95%CI(1.213,10.387)]、NT-proBNP[OR=3.991,95%CI(1.364,11.676)]均是UAP患者发生AMI的独立危险因素(P<0.05)。ROC曲线分析结果显示,NT-proBNP预测UAP患者AMI发生的敏感度为69.57%,特异度为79.81%,AUC为0.721[95%CI(0.635,0.797)]。结论:UAP严重程度及NT-proBNP水平均是UAP患者发生AMI的影响因素,NT-proBNP对UAP患者AMI发生有一定的预测价值。

Objective:To investigate the influencing factors of acute myocardial infarction(AMI)in patients with unstable angina pectoris(UAP)and the predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP)on the occurrence risk of AMI.Method:A total of 120 patients with UAP admitted to Shangrao People's Hospital from February 2021 to February 2023 were selected as the study objects.The level of NT-proBNP was detected in all patients,and the level of NT-proBNP in patients with UAP with different severity was compared.Followed up for 1 year,the occurrence of AMI in patients with UAP was recorded,and they were divided into two groups according to whether AMI occurred:occurrence group(n=23)and non-occurrence group(n=97).Multivariate logistic regression analysis was performed for UAP patients with AMI.The receiver operator characteristic(ROC)curve was drawn,and the area under the curve(AUC)was used to evaluate the predictive efficacy of NT-proBNP on the occurrence risk of AMI in patients with UAP.Result:The difference of NT-proBNP in patients with UAP with different severity was statistically significant(P<0.05).NT-proBNP in severe group was higher than that in mild group and moderate group,and NT-proBNP in moderate group was higher than that in mild group,the differences were statistically significant(P<0.05).Among 120 patients with UAP,23 cases(19.17%)occurred AMI.The proportion of severe UAP and NT-proBNP in the occurrence group were higher than those in the non-occurrence group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that severe UAP[OR=3.550,95%CI(1.213,10.387)]and NT-proBNP[OR=3.991,95%CI(1.364,11.676)]were all independent risk factors of the occurrence of AMI in patients with UAP(P<0.05).ROC curve analysis results showed that the sensitivity of NT-proBNP in predicting AMI occurrence in patients with UAP was 69.57%,Medical Innovation of China Vol.21,No.33 November,2024 and the specificity was 79.81%,the AUC was 0.721[95%CI(0.635,0.797)].Conclusion:The severity of UAP and NT-proBNP are all influencing factors of the occurrence of AMI in patients with UAP,and NT-proBNP has certain predictive value for the occurrence of AMI in patients with UAP.