NT-proBNP水平对非ST抬高型急性冠脉综合征患者冠脉闭塞病变的诊断价值

目的:探讨NT-proBNP水平与非ST抬高型急性冠脉综合征(NSTE-ACS)患者冠状动脉闭塞病变的相关性及对病变的评估价值。方法:入选符合标准的患者223例,根据冠脉造影的结果,将入选患者分为闭塞病变组和非闭塞病变组,测定两组患者的NT-proBNP水平,分析NT-proBNP水平在两组患者的差异性,对闭塞病变的相关性的危险因素进行Logistic回归分析,利用ROC曲线评估NT-proBNP 对NSTE-ACS闭塞病变的诊断价值。结果:非闭塞病变组相比,闭塞病变组NT-proBNP水平显著升高,差异具有统计学意义(P＜0.001)；多因素Logistic 回归分析显示NT-proBNP水平升高是NSTE-ACS存在闭塞病变的危险因素(OR=1.011,95%CI 1.001～1.012,P=0.002)。NT-proBNP诊断闭塞病变的ROC曲线下面积为0.724(95%CI:0.638~0.810),最佳界值点为149.50 ng/L(敏感性为80.6%,特异性为61.5%)。结论： 在NSTE-ACS闭塞病变患者中,NT-proBNP水平升高,与闭塞病变的存在相关,对于NSTE-ACS病例中闭塞病变的诊断具有评估意义。

Diagnostic value of NT-proBNP level forcoronary artery occlusion in patients with non-ST-elevation acute coronary syndrome

Objective: To explore the correlation between NT-proBNP level and coronary artery occlusion in patients with the non-ST-elevation acute coronary syndrome (NSTE-ACS) and its evaluation value.Methods: 223 patients with NSTE-ACS admitted to Tai''an Central Hospital from December 2017 to December 2019 were selected. According to the results of coronary angiography, the patients were divided into non occlusive disease group(n=156) and occlusive disease group(n=67). The NT-proBNP level of the two groups was measured and compared. The risk factors of coronary occlusion were analyzed by logistic regression, and the diagnostic value of NT-proBNP for NSTE-ACS occlusive lesions was evaluated by ROC curve.Results: Compared with the non-coronary occlusion group, the level of NT-proBNP in the coronary occlusion group was significantly higher (P<0.001); multivariate logistic regression analysis showed that high level of NT-proBNP was an independent risk factor for the presence of coronary occlusion in NSTE-ACS (OR=1.011, 95% CI 1.001-1.012, P=0.002). The area under ROC curve of NT-proBNP was 0.724 (95% CI 0.638-0.810), and the best cut-off point was 149.50 ng/L, sensitivity 80.6%, specificity 61.5%.Conclusions: In NSTE-ACS patients with coronary occlusion, the level of NT-proBNP is increased. It is of certain value to the diagnosis of NSTE ACS occlusion.