BNP水平与急性冠脉综合征远期预后相关性分析

【目的】探讨脑利尿钠肽（BNP）水平与急性冠脉综合征（ACS）发生主要心血管不良事件的相关性。【方法】收集2007年1月至2008年12月本院收治的不稳定型心绞痛（UA）、急性非ST段抬高心肌梗死（NSTEMI）及急性ST段抬高心肌梗死（STEMI）239例患者的临床资料，于2009年1月至12月根据调查问卷电话随访发生MACE情况，分析BNP与ACS及MACE的相关性。【结果]BNP水平为AMI组（NSTEMl及STEMI组）高于UA组（P〈o．01）；MACE累积发生率分别为uA组31例（26．50％），NSTEMI组57例（34．75％），STEMI组93例（38．91％），差异无显著性（P〉O．05）；NSTEMI组BNP水平大于114．5pg／mL，STEMI组BNP水平大于155．5pg／mL，MACE发生风险增加，灵敏度分别为75％、67．4％，特异度分别为90．9％、71．7％。[结论]AMI患者BNP水平高于uA患者；BNP大于114．5pg／mL及155．5pg／mL有助于预测NSTEMI及STEMI发生MACE风险．

Relationship Between BNP Level and Long-term Prognosis in Acute Coronary Syndrome

[Objective]To explore the relationship between B-type natriuretic peptid（BNP） levels and occurrence of major adverse cardiovascular event（MACE） in ACS. [Methods]The clinical data of 239 patients with unstable angina（UA）, acute non-ST-segment elevation myocardial infarction（NSTEMI） or acute ST-segment elevation myocardial infarction（STEMI） in our hospital from Jan. 2007 to Dec. 2008 were collected. Fol- low-up visit of the occurrence of MACE by phone was completed from Jan. 2009 to Dec. 2009. The relation- ship between BNP and ACS or MACE was analyzed. [Results] The BNP level in AMI group（NSTEMI group and STEMI group） was higher than that in UA group（ P d0.01）. The cumulative incidence rates of MACE were 26.50%（31 cases） in UA group, 34.75o/oo（57 cases） in NSTEMI group and 38.91%（93 cases） in STE- MI group, but there were no significant difference among them（ P 〉0.05）. BNP levels were more than 114. 5pg/ml in NSTEMI group and more than 155.5pg/mL in MACE group. With the increasing of the occurrence risk of MACE, the sensitivity in NSTEMI group and MACE group were 75 % and 67.4%, respectively, and the specificity in above two groups were 90.9% and 71.7%, respectively. [Conclusion] BNP level in AMI patients is higher than that in UA patients. BNP level more than 114.5pg/ml and 155.5pg/ml may be helpful to predict the risk of the occurrence of MACE in NSTEMI and STEMI patients.