急性冠状动脉综合征介入治疗前后脑钠肽变化及对临床预后的判断

目的通过测定急性冠状动脉综合征患者介入治疗前后血浆脑钠肽（BNP）水平的变化，探讨急性冠状动脉综合征介入治疗（PCI）对急性冠状动脉综合征患者血浆BNP变化及对临床病情和预后的判断。方法冠心病介入治疗（PCI）168例，分为存活组（143例）和死亡组（25例）；对存活组患者随访至6个月分别测定血浆BNP及死亡、再入院率，超声心动图检查（UCG）左室射血分数（LVEF）。结果PCI术后血浆BNP水平比术前明显降低，从术前的血BNP浓度在（176±27）ng／L逐渐升高，至术后6个月降低到（98±6）ng／L，与术前相比差异具有统计学意义（P〈0．05）。死亡组患者术前血BNP浓度水平比存活组明显升高（P〈0．05）。存活组和死亡组LVEF[（57．0±14．1）％比（31．0±15．0）％，P〈0．01]有统计学意义，Logistic多变量逐步回归分析显示，BNP是预测ACS患者PCI治疗预后的独立预测因子，且与LVEF呈负相关。结论PCI可降低ACS患者血液BNP水平，但术前BNP水平，常提示预后不良

Influence of percutaneous coronary intervention on BNP levels and clinical of the patients with coronary heart disease

Objective To evaluate the influence of percutaneous coronary intervention （PCI） on BNP level of the patients with coronary heart disease. Methods Plasma BNP concentrations, LVEF before and at 6 months after PCI were assayed in allpatientsl Results There were significant difference in plasma BNP level between the alive and the dead group, and also significant change after PCI, which was decreased significantly from 176 ±27.15ng/L to 98 ±6.25 ng/L after PCI. Statistical differences were observed between the alive and dead group. In patients with ACS, plasma BNP, concentration was an independent predictor after PCI with logistic regression unalysis. Conclusion Elevation of BNP concontrations was decreased by PCI in ACS may be a while elevated plasma BNP concentrations before＂ PCI revealed prognosis was bad.