血清NT-proBNP水平与冠状动脉病变程度及主要不良心血管事件的相关性分析

摘要

Objective To analyze correlation of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels with the severity of coronary artery lesions and the incidence of major adverse cardiovascular events (MACE). Methods The clinical data of 120 patients from January 2012 to December 2014 in Chongqing Qijiang People's Hospital (“our hospital”for short) was retrospectively analyzed, they were divided into the stable angina pectoris (SAP) group (37 cases), unstable angina pectoris (UAP) group (38 cases), acute myocardial infarction (AMI) group (45 cases) according to the clinical symptoms of patients;the patients were divided into 1 coronary artery lesion group (68 cases), 2 coronary artery lesions group (31 cases), and 3 coronary artery lesions group (21 cases) according to the number of coronary artery lesions;at the same time, according to whether there were MACE, they were divided into MACE group (76 cases) and without MACE group (44 cases). 35 cases confirmed without coronary heart disease at the same time in our hospital were selected as control group. The levels of NT-proBNP and Gensini scores of those groups were observed and analyzed, the correlation of NT-proBNP with Gensini scores and MACE were statistically analyzed. Results The levels of NT-proBNP in SAP group, UAP group, AMI group were significantly higher than those of the control group, the differences were statistically significant (P<0.01);the serum levels of NT-proBNP and Gensini score in the UAP group and AMI group were signif-icantly higher than those of SAP group, the differences were statistically significant (P<0.05 or P<0.01), and the lev-differences were statistically significant (P< 0.01). With the increase of coronary artery lesion counts, patient's serum level of NT-proBNP and Gensini score increased, the differences were statistically significant (P< 0.05 or P<0.01). The serum levels of NT-proBNP of the MACE group was significantly higher than that of without MACE group, the dif-ference was statistically significant (P< 0.01). Correlation analysis results showed that, patients' serum level of NT-proBNP was positively correlated with Gensini score (r=0.537, P< 0.05). Conclusion The serum level of NT-proBNP in patients with coronary heart disease has obvious correlation with the extent of coronary artery lesions, and detection of the NT-proBNP level has a certain value for the forecast of MACE.%目的：分析冠心病患者血清N末端B型利钠肽原(NT-proBNP)水平与冠状动脉病变程度及主要不良心血管事件(MACE)的相关性。方法回顾性分析2012年员月~2014年12月在重庆市綦江区人民医院(以下简称“我院”)住院的120例患者的临床资料,根据患者的临床症状将其分为稳定型心绞痛(SAP)组37例、不稳定型心绞痛(UAP)组38例、急性心肌梗死(AMI)组45例；根据患者冠状动脉病变支数分为1支组68例、2支组31例、3支组21例；同时根据是否发生MACE将患者分为非MACE组76例和MACE组44例。选择我院同期健康体检且经冠状动脉造影证实为非冠心病者35名作为对照组。观察比较各组NT-proBNP水平、Gensini评分,统计分析NT-proBNP水平与Gensini评分及MACE的相关性。结果SAP组、UAP组、AMI组患者NT-proBNP水平明显高于对照组,差异均有高度统计学意义(P<0.01)；UAP组和AMI组NT-proBNP水平及Gensini评分明显高于SAP组,差异有统计学意义(P<0.05或P<0.01)；AMI组NT-proBNP水平及Gensini评分明显高于UAP组,差异有高度统计学意义(P<0.01)。随着冠状动脉病变支数的增加,患者血清NT-proBNP水平及Gensini评分逐渐升高,差异均有统计学意义(P<0.05或P<0.01)。MACE组患者血清NT-proBNP水平明显高于非MACE组,差异有高度统计学意义(P<0.01)。相关性分析结果显示,患者血清NT-proBNP水平与Gensini评分呈正相关(r =0.537,P<0.05)。结论冠心病患者血清NT-proBNP水平与冠状动脉病变程度具有明显的相关性,且检测NT-proBNP水平对MACE的预测具有一定的价值。