非ST段抬高急性冠脉综合征患者NT-proBNP水平和GRACE评分与冠脉病变的关系

目的探讨非Sr段抬高急性冠脉综合征（NSTE-ACS）患者血浆氨基末端B型脑钠肽前体（NT-proBNP）水平和全球急性冠状动脉事件注册（GRACE）评分与冠脉病变严重程度的关系。方法入选住院的NSTE-ACS患者106例。通过电化学发光法测定血NT-proBNP水平并分析其与GRACE评分的相关性；冠脉病变按SYNTAX评分≥23和〈23分为高分组和低分组，行冠脉造影检查并分析NT-proBNP水平和GRACE评分与冠脉病变支数和冠脉病变SYNTAX评分的关系。结果①NSTE-ACS患者NT-proBNP水平和GRACE评分危险分层有明确相关性，NT-ProBNP水平越高，GRACE评分值亦越高；②NT-proBNP水平与冠脉病变支数相关，冠脉三支病变患者NT-proBNP水平和GRACE评分明显高于单支病变；SYNTAX评分高分组患者NT-proBNP水平与GRACE评分明显高于低分组。结论结合NT-ProBNP水平测定与GRACE危险评分可提高对NSTE-ACS的预测，尤其对NSTE-ACS早期介入治疗风险和预后评估有重要价值。

Correlation of NT-proBNP and GRACE score with the coronary artery stenosis in patients with non-ST segment elevation a- cute coronary syndrome

Objective To investigate the correlation of N-terminal pro-B-type natriuretic peptide（NT-proBNP）levels and global regis- try of acute coronary events（GRACE） score with the severity of coronary artery disease in patients with non-ST segment elevation acute coronary syndrome（NSTE-ACS）. Methods A total of 106 NSTE-ACS patients undergoing coronary angiography were selected. The NT-proBNP of all patients was measured by electrochemistry luminescent technique. All patients were evaluated by GRACE score, then the correlation between NT-proBNP levels and GRACE score was analyzed. The patients were divided into SYNTAX score≥ 23 group and 〈 23 group,and underwent the coronary angiography. The correlations of NT-proBNP level and GRACE score with the number of coronary lesions and SYNTAX score of coronary artery disease were analyzed. Results The NT-proBNP level was correlated with GRACE score in NSTE-ACS patients （r = 0.56, P 〈 0.01 ）. The NT-proBNP level in patients with high risk GRACE score was higher than those of moderated and low risk GRACE score（ P 〈 0.01 ）. The NT-proBNP level and GRACE score were higher in NSTE-ACS pa- tients with three branches of CAS than that of one branch （P 〈 0.05）. The NT-proBNP level and GRACE score were higher in NSTE- ACS patients with SYNTAX score ≥ 23 than those in NSTE-ACS patients with SYNTAX score 〈 23 （P 〈0. 05 ）. Conclusion Combi- nation of NT-proBNP level and GRACE risk score could increase the prediction of non-ST segment elevation acute coronary syndrome, especially for the risk and prognosis evaluation of early intervention treatment.