血浆B型钠尿肽对急性冠状动脉综合征患者心功能不全的预测价值

目的观察急性冠状动脉综合征患者血浆B型钠尿肽(BNP)、血清肌酐水平以及BNP与LVEF的关系,探讨BNP对左心室功能不全的预测价值。方法选择急性冠状动脉综合征患者126例,记录其各项危险因素,入院时检测血浆BNP及血清肌酐水平,入院第2天行超声心动检查测定LVEF。按LVEF结果分LVEF≥40%组76例和LVEF<40%组50例,分析2组患者血浆BNP水平与LVEF的相关性,并分析2组BNP、肌酐水平有无差异。结果与LVEF≥40%组比较,LVEF<40%组患者BNP、肌酐水平明显升高(P<0.05,P<0.01),ST段抬高急性冠状动脉综合征患者比例(80.0%vs 35.5%)和高血压比例(72.0%vs 51.4%)明显升高(P<0.05)。BNP与LVEF独立相关(r=-0.224,OP=1.199,95%CI:0.994～1.998,P<0.05)。LVEF<40%组患者BNP与LVEF呈负相关(r=-0.396,P=0.042),LVEF≥40%组患者BNP与LVEF无相关性(P>0.05)。结论 BNP可作为更早期对急性冠状动脉综合征患者进行危险分层并指导治疗的预测因素。

The predictive value of BNP for prognosis of cardiac dysfunction in patients with acute coronary syndrome

Objective To observe the plasma BNP and serum creatinine levels of patients suffering from acute coronary syndrome,and analyze the relationship between BNP and LVEF.Methods 126 patients were included in this study.The patients were divided into 2 groups according to LVEF:50 patients in a group with LVEF under 40%and 76 patients in another group with LVEF above 40%.Their risk factors such as hypertension,diabetes mellitus,hyperlipemia and so on were recorded.Plasma BNP and serum creatinine were measured immediately after admission, LVEF were measured on the next day.Difference in plasma BNP and serum creatinine between the 2 groups and the relationship between BNP and LVEF were analyzed.Results Compared with patients with LVEF above 40%,plasma BNP and serum creatinine were markedly higher in patients with LVEF under 40%(F<0.05,P<0.01).The proportion of patients with hypertension and ST-elevation myocardial infarction were higher in patients with LVEF under 40%(P<0.05).BNP was correlated with LVEF independently(r =- 0.224,OR = 1.199,95%C7: 0.994*1.998,F<0.05).BNP in patients with LVEF under 40%was negatively correlated with LVEF(r =- 0.396,P = 0.042).Conclusion BNP is a good predictor for early evaluation of heart function in patients suffering from ACS.