血浆脑钠肽和D-二聚体水平检测对急性冠脉综合征患者1年内再发心源性疾病的评估价值

摘要

Objective: To analyze the value of plasma BNP and D-Dimer for recurrence of cardiac disease in patients with acute coronary syndrome in one year.Method: 85 patients with acute coronary syndrome were divided into AMI group and UAP group.50 healthy peoples as control group.The level of BNP and D-Dimer were measured and all patients were followed up for 1 year.The difference of BNP and D-Dimer were compared and recurrence of cardiac diseases were observed.by multiple logistic regression The risk factors of recurrence of cardiac diseases were analyzed.ROC curve was used to assess the prognosis evaluation value of BNP and D-Dimer in patients with acute coronary syndrome.Results:The content of BNP in AMI group and UAP group were both higher than control group(P<0.01), and AMI group higher than UAP Group(P<0.01).The level of D-Dimer in AMI Group was higher than control group,there was no significant difference between UAP Group and control group(P>0.05).The level of BNP and D-Dimer in patients with recurrence of cardiac disease were both higher than other patients.Followed up for 1 year, BNP and D-Dimer were the independent risk factor for recurrence of cardiac diseases in patients with acute coronary syndrome.ROC curve analysis revealed that the optimal critical value of BNP for predicting recurrence of cardiac disease was 239.60ng/ml and D-Dimer was 178.55mg/L,the sensitivity was 70.60% and 77.10 %,the specificity was 60.50% and 64.20%.The survival rate in groups of BNP≤239.60ng/ml and D-Dimer ≤178.55 mg/L were significant higher than BNP>239.60ng/ml and D-Dimer>178.55 mg/L.Conclusion: Plasma BNP and D-Dimer were important to evaluate recurrence of cardiac disease on patients with acute coronary syndrome in1 year.%目的:分析血浆脑钠肽(BNP)、D-二聚体(D-D)水平检测对急性冠脉综合征(ACS)患者1年内再发心源性疾病的评估价值.方法:85例ACS患者分成急性心肌梗死组(AMI组)及不稳定性心绞痛组(UAP组),另选50例体检健康者为对照组.检测各组BNP、D-D水平;随访ACS患者1年内再发心源性疾病、死亡病例,多元Logistic回归分析再发心源性疾病危险因素,受试者工作特征(ROC)曲线分析BNP、D-D对患者预后评估价值,并据此计算生存率.结果:AMI组、UAP组BNP水平均明显高于对照组(P<0.01),AMI组更高(P<0.01);AMI组D-D水平明显高于对照组(P<0.01),UAP组与对照组无显著差异(P>0.05).随访1年内,再发心源性疾病和死亡患者共22例,其BNP和D-D水平均明显高于未再发心源性疾病和死亡患者(P<0.01);回归分析显示BNP、D-D是ACS患者1年内再发心源性疾病的独立危险因素,ROC曲线显示BNP、D-D分别为239.60ng/ml、178.55mg/L对ACS预后评估有较好的敏感度和特异度(敏感度分别为70.60%和77.10 %,特异度分别为60.50%和64.20%).BNP≤239.60ng/ml患者1年生存率高于BNP>239.60ng/ml者,D-D≤178.55mg/L患者1年生存率高于D-D>178.55mg/L者.结论:血浆BNP和D-D对评估ACS患者1年内再发心源性疾病和患者死亡有重要临床价值.