血浆N末端脑钠肽前体，胱抑素C检测结合急性冠脉事件注册评分评估ACS患者心功能及预后的作用

摘要

Objective:To assess effect of detection of plasma N terminal pro brain natriuretic peptide (NT‐proBNP) and serum cystatin C (Cys C) combined Global Registry of Acute Coronary Events (GRACE) score on heart func‐tion and prognosis in patients with acute coronary syndrome (ACS) .Methods :According to GRACE score ,a total of 136 ACS patients were divided into low risk group (n=29) ,intermediate risk group (n=39) and high risk group (n=68) .Serum Cys C level and plasma NT‐proBNP level were measured in all groups .Incidence rate of major ad‐verse cardiovascular events (MACE) within three and six months was counted .Results:Among ACS patients ,com‐pared with low risk group ,there were significant rise in levels of NT‐proBNP [ (165.80 ± 51.62) ng/L vs .(193.13 ± 74.64) ng/L vs .(985.45 ± 152.69) ng/L] and Cys C [ (0.83 ± 0.38) mg/L vs .(0.9 ± 0.25) mg/L vs .(1.23 ± 0.23) mg/L] ,left ventricular end‐diastolic diameter [six months: (50 ± 3) mm vs .(55 ± 3) mm vs .(59 ± 5) mm] ,significant reduction in left ventricular ejection fraction [LVEF ,six months: (55 ± 7)% vs .(49 ± 5)% vs . (40 ± 7)% ] ,and significant rise in incidence rate of MACE (six months:2.94% vs .9.55% vs .30.88% ) ,and a‐bove indexes in high risk group were significantly higher than those of intermediate risk group except LVEF signifi‐cantly reduced , P<0.05 or <0.01 ;Pearson correlation analysis indicated that NT‐proBNP and Cys C levels were positively correlated with GRACE score (r=0.72 , P<0.05 ; r=0.65 , P<0.05) respectively .Conclusion:NT‐proBNP and Cys C level detection combined GRACE score could exactly response heart function and prognosis .%目的：血浆N末端脑钠肽前体，胱抑素C检测结合急性冠状动脉事件注册评分评估ACS患者心功能，主要不良心血管事件（ M ACE ）的作用．方法：入选 ACS 患者136例，根据 GRACE评分分为低（29例）、中（39例）、高危组（68例），检测各组血清Cys C及血浆 NT‐proBNP水平，心功能，统计3、6个月内 MACE发生率。结果：在ACS患者中，与低危组比较，中危组和高危组NT‐proBNP [（165.80±51.62） ng／L比（193.13±74.64） ng／L比（985.45±152.69） ng／L]、Cys C [（0.83±0.38） mg／L比（0.9±0.25） mg／L比（1.23±0.23） mg／L]水平显著升高，左室舒张末期内径[6个月：（50±3） mm比（55±3） mm比（59±5） mm]明显增加，左室射血分数[LVEF ，6个月： （55±7）％比（49±5）％比（40±7）％]显著降低，不良心血管事件发生率（6个月：2.94％比9.55％比30.88％）明显升高，且高危组上述各项（除LVEF显著降低外）均显著高于中危组， P＜0.05或＜0.01；Pearson相关分析显示， NT‐proBNP、Cys C水平与 GRACE危险积分分别呈正相关（r＝0.72， P＜0.05；r＝0.65， P＜0.05）。结论：NT‐proBNP及Cys C水平检测结合GRACE评分，能准确反映心功能、评估预后。