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N末端原脑钠肽对急性冠状动脉综合征患者远期预后的预测价值
引用本文:衣志勇,李小鹰,蒋知新,孙玉发,查政,刘亚巍,袁凤仪,袁向珍,李庆勇. N末端原脑钠肽对急性冠状动脉综合征患者远期预后的预测价值[J]. 中华老年医学杂志, 2011, 30(2). DOI: 10.3760/cma.j.issn.0254-9026.2011.02.007
作者姓名:衣志勇  李小鹰  蒋知新  孙玉发  查政  刘亚巍  袁凤仪  袁向珍  李庆勇
作者单位:1. 总参警卫局保健处,北京,100017
2. 解放军总医院南楼心血管科
3. 解放军第三○五医院中心实验室
基金项目:全军"十一五"医药卫生科研基金
摘    要:目的 探讨N末端原脑钠肽(NT-proBNP)水平对早期急性冠状动脉综合征(ACS)患者远期预后的预测价值.方法 ACS患者164例,测定入院首次(<12 h)血NT-proBNP水平,以NT-proBNP水平75%分位及以下为基线水平(低值组123例)与75%分位以上(高值组41例)的心血管不良事件进行1个月、6个月和≥12个月随访和比较分析.结果 高值组与低值组比较,1个月、6个月和≥12个月死亡的危险度(OR)分别为4.1、5.6和4.0,高值组非致死性心力衰竭为4例、4例和7例,而低值组分别为0、1例和1例,多因素Logistic回归分析结果表明,NT-proBNP仍为ACS患者近期、中期和远期不良事件的独立危险因素(P<0.05).结论 NT-proBNP是早期急性ACS远期心血管不良事件的预测因子.
Abstract:
Objective To explore the long-term predictive value of serum concentration of N-terminal prosoma brain natriuretic peptide (NT-proBNP) in the early acute coronary syndrome (ACS). Methods The 164 patients firstly hospitalized and finally diagnosed as acute myocardial infarction (AMI) were selected, and then the serum concentration of NT-proBNP was determined in less than 12 hours. According to the 75 percentage points of serum concentration of NT-proBNP, the patients were divided into two groups: low concentration group (n = 123) and high concentration group (n = 41 ). The major adverse cardiac events (MACEs) were followed and compared at one month, six months and twelve months between low group and high group. Results At 1-, 6-, 12-month follow-up, the odds ratio (OR) of death event were 4.1, 5.6 and 4.0 in high group respectively, and the nonfatal heart failure occurred in 4, 4 and 7 patients in high group. Multiple factor logistic regression analysis showed that NT-proBNP was an independent risk factor of the MACEs at different periods including short time, middle time and long time in ACS patients (P<0. 05). Conclusions NT-proBNP is a strong predictor of the long-term MACEs in patients with early ACS.

关 键 词:冠状动脉疾病  利钠肽,脑  预后

Long-term prognostic value of N-terminal prosoma brain natriuretic peptide in patients with acute coronary syndrome
YI Zhi-yong,LI Xiao-ying,JIANG Zhi-xin,SUN Yu-fa,CHA Zheng,LIU Ya-wei,YUAN Feng-yi,YUAN Xiang-zhen,LI Qing-yong. Long-term prognostic value of N-terminal prosoma brain natriuretic peptide in patients with acute coronary syndrome[J]. Chinese Journal of Geriatrics, 2011, 30(2). DOI: 10.3760/cma.j.issn.0254-9026.2011.02.007
Authors:YI Zhi-yong  LI Xiao-ying  JIANG Zhi-xin  SUN Yu-fa  CHA Zheng  LIU Ya-wei  YUAN Feng-yi  YUAN Xiang-zhen  LI Qing-yong
Abstract:Objective To explore the long-term predictive value of serum concentration of N-terminal prosoma brain natriuretic peptide (NT-proBNP) in the early acute coronary syndrome (ACS). Methods The 164 patients firstly hospitalized and finally diagnosed as acute myocardial infarction (AMI) were selected, and then the serum concentration of NT-proBNP was determined in less than 12 hours. According to the 75 percentage points of serum concentration of NT-proBNP, the patients were divided into two groups: low concentration group (n = 123) and high concentration group (n = 41 ). The major adverse cardiac events (MACEs) were followed and compared at one month, six months and twelve months between low group and high group. Results At 1-, 6-, 12-month follow-up, the odds ratio (OR) of death event were 4.1, 5.6 and 4.0 in high group respectively, and the nonfatal heart failure occurred in 4, 4 and 7 patients in high group. Multiple factor logistic regression analysis showed that NT-proBNP was an independent risk factor of the MACEs at different periods including short time, middle time and long time in ACS patients (P<0. 05). Conclusions NT-proBNP is a strong predictor of the long-term MACEs in patients with early ACS.
Keywords:Coronary disease  Natriuretic peptide,brain  Prognosis
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