血浆NT-proBNP水平与冠心病严重程度和预后的相关性分析

目的 分析血浆氨基末端B型脑钠肽前体(N-terminal B-type natriuretic peptide precursor,NT-proBNP)与冠心病严重程度及预后的相关性.方法 收集医院2015年1月至2017年6月收治的200例冠心病患者的临床资料,选择同期来医院体检的50例正常健康人作为对照组,入院后均测定NT-proBNP水平,比较冠心病患者与正常健康人NT-proBNP水平的差异及不同病情严重程度、不同预后冠心病患者血浆NT-proBNP水平的差异,分析血浆NT-proBNP水平与冠心病严重程度及预后的关系.结果 对照组NT-proBNP水平低于冠心病患者(P＜0.05),急性心肌梗死(acute myocardial infarction,AMI)、不稳定型心绞痛(unstable angina,UAP)患者NT-proBNP水平明显高于稳定型心绞痛(stable angina pectoris,SAP)患者(P＜0.05),AMI患者血浆NT-proBNP水平又高于UAP患者(P＜0.05);狭窄程度为Ⅱ～Ⅳ级患者血浆NT-proBNP水平高于Ⅰ级患者(P＜0.05),Ⅲ～Ⅳ级患者血浆NT-proBNP水平又高于Ⅱ级(P＜0.05),Ⅳ级患者血浆NT-proBNP水平又高于Ⅲ级患者,比较差异均有统计学意义(P＜＜0.05);主要不良心脏事件(major adverse cardiac events,MACE)组患者血浆NT-proBNP水平明显高于无MACE组,比较差异有统计学意义(P＜0.05);冠心病狭窄程度、MACE事件发生率与血浆NT-proBNP水平呈正相关(r=0.721、0.896,P均＜0.05).结论 冠心病患者血浆NT-proBNP水平明显升高,且随冠心病严重程度的上升,血浆NT-proBNP水平升高,且其水平升高通常提示不良预后.

Correlation Between Plasma NT-proBNP Levels and the Severity and Prognosis of Coronary Heart Disease

Objective To analyze the correlation between plasma N-terminal B-type brain natriuretic peptide (NT-proBNP) and the severity and prognosis of coronary heart disease (CHD).Methods The clinical data from 200 patients with CHD treated in our hospital from January 2015 to June 2017 were collected,and 50 healthy people who were admitted to the hospital for physical examination during the same period were selected as the control group.Level of NT-proBNP was determined after admission,and compared between patients with CHD and healthy people,between patients with different severities of CHD and between patients with different prognosis.The relationship between plasma NT-proBNP level and the severity and prognosis of CHD was analyzed.Results NT-proBNP level in the control group was lower than those in patients with CHD (P ＜ 0.05).The results showed:NT-proBNP level in patients with acute myocardial infarction (AMI) ＞ that in patients unstable angina pectoris (UAP) ＞ that in patients with stable angina pectoris (SAP) (all P ＜ 0.05).The plasma NT-proBNP level was higher in patients with grade Ⅱ-Ⅳ stenosis than that in patients with grade Ⅰ stenosis,that in patients with grade Ⅲ-Ⅳ stenosis was higher than that in patients with grade Ⅱ stenosis,and that in patients with grade Ⅳ stenosis was higher than that in patients with grade Ⅲ stenosis (all P ＜ 0.05).The plasma NT-proBNP level in patients with major adverse cardiac events (MACE) was significantly higher than that in patients without MACE (P ＜ 0.05).The degree of coronary artery stenosis and the incidence of MACE were positively correlated with plasma NT-proBNP levels (r =0.721,0.896,P ＜0.05).Conclusion The plasma NT-proBNP level is relatively high in patients with CHD.With the aggravation of CHD,plasma NT-proBNP level increases,and the increased level usually indicates poor prognosis.