脑钠肽结合Gensini积分对急诊PCI患者近期预后评估临床研究

目的探讨脑钠肽（BNP）结合Gensini积分对急诊经皮冠状动脉介入治疗（PCI）术后患者近期预后的评估价值。方法急性心肌梗死（AMI）患者82例，人院后测定血BNP浓度，急诊行冠状动脉造影检查并计算Gensini积分，术后第2天测BNP，随访患者6个月内主要心血管不良事件的发生率。结果AMI患者急诊PCI术后第2EtBNP水平明显低于术前，差异有统计学意义（P〈0．05）。BNP水平〉500ng／L组的患者6个月内发生主要心血管不良事件的概率高于〈500ng／L组的患者，差异有统计学意义（P〈0．05）。BNP水平与Gensini积分呈正相关（r=0．265，P〈0．05）。随访6个月，82例患者中13例发生主要心血管不良事件，发生者BNP水平和Gensini积分均高于未发生者，差异有统计学意义（P〈0．05）。结论AMI患者PCI术前BNP水平显著高于术后，且与Gensini积分及近期预后有关。BNP可作为AMI患者急诊PCI术后近期预后的预测指标。

The clinical short-term prognostic value of BNP and Gensini score in patients with emergency PCI

Objective To investigate the relationships between B - type natriuretic peptide （BNP） and the extent of coronary artery lesions in patients with acute myocardial infarction （AMI）, and to assess the clinical prognostic value. Methods 82 patients with AMI, BNP of the patients were designed as control group after operation. All of the patients received plasma BNP measurement and angiographic examination and were followed up for 6 months for major adverse car- diovascular events （MACE）. Results BNP reduced significantly after opration （ P 〈 0.05 ）. Significant differences in occurrence rate of MACE was found between A group and B group（P 〈0.05 ）. There was a positive correlation between levels of BNP and Gensini score in AMI patients. The corresponding Spearman correlation coefficients was r = 0.265 （ P 〈 0.05 ）. There were 13 patients suffered from MACE during the follow up period. BNP and Gensini score levels were sig- nificantly higher in MACE patients （ P 〈 0.05 ）. Conclusion The level of BNP in patients reduce significantly after opration . There is a correlation between levels of BNP and Gensini score and prognosis indicator in AMI patients. BNP is a short - term prognostic factor for AMI patients treated with emergency PCI.