氮末端脑钠肽前体与急性心肌梗死近期预后的关系

目的：探讨血浆氮末端脑钠肽前体（NT proBNP）水平与急性心肌梗死（AMI）近期预后的关系。方法：选取102例首发AMI患者进行血浆NT proBNP水平测定，经平均6个月随访，观察患者住院期间及6个月时病死率、心脏主要不良事件（MACE）发生率与血浆NT proBNP水平的关系。结果：AMI后急性期血浆NT proBNP水平明显升高，AMI组血浆NT proBNP水平明显高于对照组，差异具有统计学意义（P＜0.01）。随着血浆NT proBNP水平的升高AMI患者病死率及MACE发生率呈明显递增趋势。在多变量logistic回归分析中，血浆NT proBNP水平独立于性别、年龄、家族史、吸烟、高脂血症、高血压、糖尿病等冠心病危险因素，预测6个月病死率（r=0.943?7, P＜0.01）和MACE发生率（r=0.607?2, P＜0.01）。结论：AMI 患者血浆NT proBNP水平与其近期预后相关。

Relationship between plasma N-terminal pro-brain natriuretic peptide and the short-term prognosis of acute myocardial infarction

To investigate the short term prognostic value of plasma N terminal pro brain natriuretic peptide (NT proBNP) on acute myocardial infarction. Method: A total of 132 subjects, including 30 healthy subjects and 102 patients with a first AMI were selected into the study. The plasma NT proBNP was measured at 48 to 96 hours after infarction. Total mortality and the risk for major adverse cardiac events (MACE, including death, recurrent MI, recurrent angina, heart failure, readmission for any reason) were analyzed. Results： Six months later, plasma NT proBNP was much higher in patients with AMI than that in health controls (326.1±193.4 pmol/L vs 73.5±58.3 pmol/L, P＜0.01 ). With the increasing of NT proBNP, the 6 month mortality and the incidence of MACE had been raising. Multivariate logistic regression analyses showed that the plasma NT proBNP concentration predicted 6 month mortality （r=0.943?7, P＜0.01）and incidence of MACE（r=0.607?2, P＜0.01）. Conclusion： The plasma NT proBNP level has relation with short term prognosis of AMI.