凌云;赵昌明;
LING Yun;ZHAO Changming;Department of Emergency,Shanghai Pudong New Area of Public Hospital;

• 1:浦东新区公利医院急诊科

摘要(Abstract)：

目的:探讨N端脑钠肽前体(NT-pro BNP)预测急性非ST段抬高心肌梗死(NSTEMI)患者急性血管闭塞和心源性死亡的作用。方法:51例NSTEMI患者分为冠脉闭塞组和冠脉非闭塞组,2组患者行常规心脏B超检查,血清心肌肌钙蛋白I(c Tn I)和NT-pro BNP检测;观察2组患者12个月内心源性死亡的发生情况,分析NT-pro BNP、c Tn I和左心室射血分数(LVEF)预测血管急性闭塞和心源性死亡的准确度及与预后有关的因素。结果:冠脉闭塞组患者血浆NT-pro BNP和c Tn I均高于冠脉非闭塞组(P<0.01),2组患者二维B超结果比较,差异无统计学意义(P>0.05);血浆NT-pro BNP预测NSTEMI患者发生血管急性闭塞的准确度接近c Tn I,而高于LVEF;NT-pro BNP预测NSTEMI患者发生心源性死亡的准确度明显高于c Tn I和LVEF;NT-pro BNP、c Tn I及LVEF是NSTEMI患者发生心源性死亡的独立危险因子,相对危险度分别为1.000,0.968和0.979。结论:血浆NT-pro BNP预测NSTEMI患者发生血管急性闭塞和心源性死亡的准确度较高。
Objective: To investigate the function of N-terminal brain natriuretic peptide( NT-pro BNP) to predict acute vascular occlusion and cardiac death in patients with acute non-ST segment elevation myocardial infarction( NSTEMI). Methods: Fifty-one NSTEMI patients were divided into coronary artery occlusion group and coronary artery non-occlusion group. All patients underwent routine cardiac B-ultrasound test,cardiac troponin I( c Tn I) and NT-pro BNP testing; the occurrence of cardiac death of two groups was observed for 12 months. Analyzing c Tn I,NT-pro BNP and LVEF accuracy in predicting acute vascular occlusion and cardiac death and observing prognosis relevant factors. Results: c Tn I and NT-pro BNP values of plasma of coronary artery occlusion group were much higher than the non-occlusion group( P < 0. 01),comparison of B-ultrasound test results showed no statistical significance( P > 0. 05); accuracy of plasma NT-pro BNP in predicting acute vascular occlusion was close to c Tn I but higher than LVEF; accuracy of NT-pro BNP in predicting cardiac death was significantly higher than c Tn I and LVEF. NT-pro BNP,c Tn I and LVEF were the independent risk factors of cardiac death for NSTEMI patients,relative risk were 1. 000,0. 968 and 0. 979. Conclusion: The accuracy of plasma NT-pro BNP in prediction of NSTEMI patients with vascular occlusion and cardiac death is higher.

关键词(KeyWords)： 心肌梗塞;非ST段抬高;N端脑钠肽前体;心肌肌钙蛋白I;左心室射血分数
myocardial infarction;non-ST segment elevation;N-terminal brain natriuretic peptide;cardiac troponin I;left ventricular ejection fraction

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 凌云;赵昌明;
LING Yun;ZHAO Changming;Department of Emergency,Shanghai Pudong New Area of Public Hospital;

Email:

DOI: 10.19367/j.cnki.1000-2707.2015.11.031

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