B型钠尿肽在非ST段抬高性心肌梗死与不稳定性心绞痛中的早期鉴别诊断及预后危险分层评估

摘要

目的 分析非ST段抬高性心肌梗死(NSTEMI)与不稳定性心绞痛(UA)早期B型钠尿肽(BNP)水平的差异,评估BNP在心血管疾病中早期鉴别诊断和长期预后评估中的临床价值.方法 检测就诊于天津市第三中心医院NSTEMI患者60例及UA患者50例的BNP水平,作相关性比较分析,并随访出院后6个月内不良心血管事件的发生率.结果(1)NSTEMI患者血清BNP水平明显高于UA患者(P<0.01);(2)随访6个月内110例患者中有32例发生主要不良心血管事件,其中UA组5例,NSTEMI组27例.(3)NSTEMI患者发生不良心血管事件的危险性明显高于UA患者(P<0.01).结论 与UA患者相比,NSTEMI患者早期BNP水平明显升高并与近期心血管事件的发生有一定相关性,因此可应用于与UA的早期鉴别诊断及预后危险分层评估.%Objective To evaluate the difference of B-type natriuretic peptide(BNP)levels between patients with Non-ST elevation myocardial infraction(NSTEMI)and those with unstable angina(UA)and to ex-plore its relationship with the risk factors of major adverse cardiovascular events(MACE)and its value in progno-sis. Methods BNP levels of 110 consecutive patients with NSTE-ACS including 60 cases of NSTEMI and 50 of UA were studied and the incidence of MACE within 6 months after discharge was followed. Results(1)BNP lev-els were higher in NSTEMI group than those in UA group.(2)There were 32 patients suffering from MACE during the following-up.BNP levels were significantly higher in patients with MACE.(3)The risk of suffering from MACE was greater in NSTEMI patients than that in UA patients. Conclusions The level of blood BNP can be used in the differential diagnosis between UA and NSTEMI.Meanwhile,it correlates with the clinical severity and outcome of NSTEMI and may potentially be used as a prognostic marker for NSTEMI.