AMI患者血清NT-proBNP水平在预测心脏功能中的临床意义

目的:通过观察急性心肌梗死(AMI)患者在发病第3天血清N末端B型脑钠肽前体(NT-proBNP)的水平与患者发病3个月时左室舒末容积的增加率之间的关系,探讨血清NT-proBNP水平作为AMI预测晚期左室重构的指标的可能性。方法:选择106例前壁、前间壁及前侧壁AMI患者,分别在患者发病第3天和3个月时做超声心动图测定左室舒末容积,依据左室舒末容积的增加率(Cutoff值定为0.2,目前我国诊断左室重构的指标之一),将患者分为左室重构组及非左室重构组;采用电化学免疫发光法检测血清NT-proBNP水平。结果:AMI后3个月时左室舒末容积较基础值增加率与NT-proBNP水平的相关系数为0.702,P<0.001。血清NT-proBNP的ROC曲线下面积为0.892,其cutoff值为952pg/ml。结论:AMI患者血清NT-proBNP水平是评估AMI后晚期心脏功能的较理想的指标。

The Predictive Value of Serum Level of N-Terminal Pro-Brain Natriuretic Peptide in Heart Function after Acute Myocardial Infarction

Objective: To observe the correlation between the levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) on the 3rd day after acute myocardial infarction(AMI) and left ventricular remodeling to evaluate the predictive levels of NT-proBNP for left ventricular remodeling after AMI.Method: In 106 patients with first MI were examined after three days and 3 months with blood samples and echocardiography.Left ventricular remodeling is estimated by the change of left ventricular end-diastolic volume (LVEDV) between the 3rd day and 3 months. Based on the change of LVEDV, the 106 patients were divided into two groups: left ventricular remodeling group and non-left ventricular remodeling group.Results: The correlation coefficients with the change of LVEDV were 0.702 for serum NT-pro BNP. With a cutoff value of 0.20, the area under the ROC curve (AUCs) was 0.892.Conclusion: The levels of serum of NT-proBNP appropriately reflects heart function after AMI.