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血浆B型钠尿肽检测对ACS危险分层和预后判断的意义
引用本文:钱琦,马根山,陈忠,冯毅,李拥军,陈立娟,蒋益波.血浆B型钠尿肽检测对ACS危险分层和预后判断的意义[J].江苏医药,2008,34(4):336-338.
作者姓名:钱琦  马根山  陈忠  冯毅  李拥军  陈立娟  蒋益波
作者单位:1. 东南大学临床医学院,南京,210009
2. 附属中大医院心脏病科
摘    要:目的 探讨血浆B型钠尿肽(BNP)快速床旁检测对急性冠脉综合征(ACS)危险分层和预后判断的意义.方法 ACS患者67例ST段抬高心肌梗死(STEMI)组27例、非STEMI(NSTEMI)组20例、不稳定型心绞痛(UA)组20例]和稳定型心绞痛(SA)患者20例,入院24h内行床旁BNP快速测定,随访并对比分析30、90d内主要不良心脏事件(MACE).结果 ACS患者血浆BNP(559.59±535.16)(pg/ml)明显高于SA患者的(23.28±11.69)(pg/ml)(P<0.05);其中,STEMI组(1050.59±932.31)(pg/ml),明显高于NSTEMI组的(357.65±263.48)(pg/ml)和UA组的(98.69±96.99)(pg/ml)(P<0.05);冠脉3支病变组(972.54±224.05)(pg/ml),明显高于1支病变组的(249.29±192.10)(pg/ml)(P<0.01);BNP对30d内病死率预测的ROC曲线下面积(AUC)为0.89(95%CI为0.81~0.97)(P<0.05);当BNP>100pg/ml时其敏感性75%,特异性97%,准确性81%;3个月MACE预测的AUC为0.79(95%CI为0.67~0.90)(P<0.05),当BNP>100pg/ml时其敏感性84%,特异性69%,准确性64%.结论 ACS患者床旁快速检测BNP水平有助于ACS的危险分层和预后判断.

关 键 词:急性冠脉综合征  B型钠尿肽  危险分层
文章编号:0253-3685(2008)04-0336-03
修稿时间:2007年10月23

Significance of brain natriuretic peptide in early risk stratification and prognosis of acute coronary syndromes
QIAN Qi,MA Genshan,CHEN Zhong,et al..Significance of brain natriuretic peptide in early risk stratification and prognosis of acute coronary syndromes[J].Jiangsu Medical Journal,2008,34(4):336-338.
Authors:QIAN Qi  MA Genshan  CHEN Zhong  
Institution:QIAN Qi,MA Genshan,CHEN Zhong,et al.Medical College,Southeast University,Nanjing 210009,CHINA
Abstract:Objective To explore the variation and significance of brain natriuretic peptide(BNP) level in patients with acute coronary syndrome(ACS). Methods Of 67 ACS patients,27 cases had ST elevated myocardial infarction (STEMI),20 cases non-ST elevated myocardial infarction (NSTEMI),20 cases unstable angina (UA) and 20 stable angina(SA) patients(control group) with normal heart function. Rapid bedside measurements of BNP were performed,and the incidences of main abnormal cardial event(MACE) were recorded during 30...
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