血浆脑钠肽水平与急性冠状动脉综合征患者心血管事件的相关性研究

摘要

目的：探讨血浆脑钠肽（BNP）与急性冠状动脉综合征（ACS）患者发生主要不良心血管事件（MACE）的相关性。方法收集该院就诊的ACS患者210例，检查住院期间的BNP ，并记录住院期间和出院后30 d MACE的发生情况。根据BNP的不同，把ACS患者分成两组（A组：BNP＜100 pg/mL ；B组：BNP≥100 pg/mL），比较两组患者发生MACE的差异。结果 B组患者的平均年龄为（65．9±11．4）岁，明显高于A组的（62．6±10．3）岁（P＝0．03）；B组S T段抬高型心肌梗死患者占53．7％，高于A组的34．3％（ P＝0．005）；两组患者在性别、糖尿病、高血压、血脂异常和吸烟史等方面差异无统计学意义（P＞0．05）。住院期间，B组MACE的发生率为17．6％，明显高于A组的4．9％（P＝0．004）；B组心因性病死率和再发心肌梗死率均明显高于A组（P＜0．05）。入院至出院后1个月，B组MACE的发生率为33．3％，明显高于A组的9．8％（P＜0．01）；B组心因性病死率、再发心肌梗死率和再次血运重建率均明显高于A组（P＜0．05）。结论血浆BNP水平的增高，增加ACS患者短期MACE的发生率。临床上对BNP＞100 pg/mL的ACS患者应给予更多的关注。%Objective To investigate the relationship between brain natriuretic peptide (BNP) and major ad-verse cardiovascular events(MACE) in acute coronary syndrome(ACS) patients .Methods Two hundred and ten ACS patients ,treated in this hospital ,were enrolled .Plasma BNP was detected ,and MACE during hospitalization and within 30 days after discharging were collected .According to plasma BNP level ,all patients were divided into group A ,with BNP<100 pg/mL ,and group B ,with BNP≥100 pg/mL .MACE were compared between the two groups .Re-sults The mean age of group B was (65 .9 ± 11 .4)years ,which was significantly higher than the (62 .6 ± 10 .3)years of group A(P=0 .03) .The proportion of patients with ST segment elevation myocardial infarction (STEMI) in group B was 53 .7% ,which was significantly higher than the 34 .3% in group A(P=0 .005) .However ,the differences of sex ,diabetes ,hypertension ,dyslipidemia and smoking were not statistically significant (P>0 .05) .During hospitaliza-tion ,incidence rate of MACE in group B was 17 .6% ,which was higher than the 4 .9% of group A(P=0 .004) ,and cardiac mortality and recurrence of myocardial infarction in group B were also higher than group A (P<0 .05) .One-month after discharging ,incidence rate of MACE in group B was 33 .3% ,which was higher than the 9 .8% in group A(P<0 .01) ,and cardiac mortality ,recurrence of myocardial infarction and re-revascularization of group B were also higher than group A(P<0 .05) .Conclusion Incidence rate of short-term MACE might be increased in ACS patients with the increasing of plasma BNP levels .To ACS patients with BNP≥100 pg/mL ,more attention should be paid in clinical works .