急性心肌梗死N末端B型钠尿肽系列测定与心力衰竭短期预后的关系

目的 研究急性心肌梗死（AMI）患者N末端B型钠尿肽（NT-proBNP）系列测定与短期心力衰竭的临床关系.方法 110名急性心肌梗死患者分为心力衰竭组和非心力衰竭组,测定入院时、24h、7d的血浆NT-proBNP浓度及超声心动检查,所有患者自入院起随访30 d.结果 两组患者在入院时、24 h、7d血浆NT-proBNP水平差异均有统计学意义（P〈0.01）.非心力衰竭组血浆24 h、7d NT-ProBNP水平较入院时无显著性差异（P〉0.05）,而心力衰竭组患者血浆24 h、7d NT-ProBNP水平持续增高,两者有统计学差异（P〈0.01）.同时,NT-ProBNP水平与超声心动检查中的LVEF呈负相关（P〈0.05）,与LVEDD呈显著的正相关（r=0.452,P〈0.01）.结论 血浆NT-ProBNP水平是心肌梗死后发生早期心力衰竭的预测因子,并且NT-ProBNP水平的系列测定与单一基线水平测定相比,其预后判断价值显著增加.

Relations of NT - proBNP and short - term prognosis of heart failure in acute myocardial infarction

Objective To investigate the relationship between serial NT - proBNP levels and short - term prognosis of heart failure in AMI patients. Methods One hundred and ten patients with acute myocardial infarction were divided into two groups： heart failure group and non - heart failure group. The rapid plasma NT - proBNP levels were measured in all patients before treatment and at 24 hours, 7 day after treatment. All patients were followed up after admission for 30d. Results At admission and at 24h, 7d immediately, there was significant difference between two groups. NT - proBNP levels in non - heart failure group was no significantly difference at admission and at 24h, 7d after admission （ P 〉 0. 05 ）, but NT - ProBNP levels in heart failure group increased significantly at 24h, 7d after admission （ P 〈 0.01 ）. UCGs showed that LVEF and LVEDD in no - heart failure group were better than in heart failure group at 7d after admission. NT - proBNP level was negatively correlated to LVEF （r = -0. 393, P 〈0. 01 ）, but positively correlated with LVEDD （r =0. 425, P 〈0. 01 ）. NT - proBNP levels at admission and at 24h, 7d were markedly correlated to the occurrence of heart failure events （ P 〈 0. 01 ）. Conclusion The plasma NT - BNP levels could be a predictor for occurrence of heart failure in AMI patients, and serial NT - BNP measurements are superior to a single BNP value obtained at baseline.