急性冠状动脉综合征患者NT-proBNP界值点的意义

目的探讨急性冠状动脉综合征（ACS）患者氨基末端B型钠尿肽原（NT-proBNP）界值点的意义。方法采用Roche Modu lar E170全自动电化学发光免疫分析仪测定292例住院患者入院时血清NT-proBNP水平,记录随访10个月间患者再次发生主要不良心血管事件的情况。应用受试者工作特征曲线确定NT-proBNP水平截断点,根据该值将患者危险分层分为高危组（141例）和低危组（151例）。结果血清NT-proBNP水平危险分层的最佳截断点取608 ng/L,其敏感性为81.3%,特异性为61.7%。高危组中发生不良心血管事件54例（38.3%）,无事件者为87例（61.7%）;而低危组中发生不良心血管事件11例（7.3%）、无事件者为140例（92.7%）。高危组预后情况较低危组更差P〈0.001,相对危险度（RR）：5.25,95%可信区间（CI）：2.60-10.59]。结论血清NT-proBNP水平对ACS患者危险分层的最佳截断点为608 ng/L。

Significance of the cut-off point of N-terminal pro-B-type natriuretic peptide in patients with acute coronary syndrome

Objective To explore the value of the cut-off point of the N-terminal pro-B-type natriuretic peptide（NT-proBNP） in patients with acute coronary syndrome（ACS）.Methods Serum NT-proBNP levels were measured in 292 ACS patients at admission by Roche Modular E170 automatic electrochemilum-inescent immunoassay.The major adverse cardiovascular events during the following 10 months were observed.The cut-off point of the NT-proBNP level was determined by receiver operating characteristic curve.292 ACS patients were classified into two groups high risk group（141 cases） and low risk group（151 cases）],according to the cut-off point.Results The best cut-off point of serum NT-proBNP level was 608 ng/L,and its sensitivity and specificity were 81.3% and 61.7% respectively.There were 54（38.3%） patients with adverse cardiovascular event and 87（61.7%） patients without it in the high risk group.There were 11（7.3%） and 140（92.7%） patients with and without adverse cardiovascular event in the low risk group,respectively.The prognosis of the high risk group was no significantly better than that of the low risk group P0.001,relative rate（RR）：5.25,95% confidence interval（CI）： 2.60-10.59].Conclusions The best cut-off point of serum NT-proBNP level for risk stratification in ACS patients is 608 ng/L.