急性心肌梗死患者B型钠尿肽水平与病情及预后的相关性

目的探讨急诊急性心肌梗死患者B型钠尿肽（B-type natriuretic peptide, BNP）水平与病情及预后的相关性。方法选取急诊急性心肌梗死并急诊行经皮冠状动脉造影术（ coronary artery angiography, CAG）的患者127例，根据其手术前BNP水平分为A、B组，A组42例，其BNP≥250pg/ml，B组85例，其BNP〈250pg／ml，对两组患者的辅助治疗情况进行比较，并随访6个月，记录并比较主要不良心脏事件（ Major Adverse Cardiovascular Events，MACE）、病死率的差异。同时分析BNP水平与冠脉病变严重程度、Killip心功能分级相关性。结果与B组患者相比，A组患者半年病死率高、辅助治疗比例高，两组患者病死率、辅助治疗比例有明显差别（P=0．027，P=0．006），半年内MACE发生率无明显差异。术前BNP水平与Killip心功能分级、冠脉病变支数具有相关性（rs=0．355，P〈0．0001；rs=0．289，P=0．001）。结论急性心肌梗死患者术前急诊检测BNP水平，对预测病变严重程度、辅助治疗可能性、半年病死率等有较好的临床价值。

Plasma B-type natriuretic peptide levels in relation to extent of coronary artery lesion and prognosis in acute myocardial infarction

Objective To investigate the value of plasma B-type natriuretic peptide （BNP） levels in predicting outcome and the extent of coronary artery lesion for patients with acute myocardial infarction （AMI）. Methods One hundred and twenty seven AMI patients received emergency coronary artery angiography （CAG）, the plasma BNP levels were tested before CAG. Plasma BNP levels were ≥ 250 pg/ml in 42 patients （group A） and 〈 250 pg/ml in 85 patients （group B ）. All cases were followed up for 6 months, and the adjuvant therapies, the major adverse cardiovascular events （MACE） and mortality were observed and compared between two groups. The correlation of BNP levels with the extent of coronary artery lesions and Killip class were analyzed. Results Higher levels of plasma BNP were related to higher mortality and more adjuvant therapies （ P = 0.027, P = 0.006,respectively）. The plasma BNP levels were positively correlated with Killip class and the branches involved of coronary artery lesions in AMI patients （rs =0.355 ,P 〈0.000 1 ;rs =0.289, P =0.001, respectively）. Conclusion Plasma BNP levels tested before procedure can be used as an useful predictor for adjuvant therapies, coronary artery lesion and mortality in patients undergoing emergency percutaneous coronary intervention （PC/）.