冠心病患者PCI术后6个月血浆NT-proBNP水平的变化及临床意义

目的: 观察冠心病患者行经皮冠状动脉介入治疗（PCI）前和6个月以后血浆中氨基末端脑钠尿肽前体（N-terminal pro-brain natriuretic peptide, NT-proBNP）水平的变化，探讨其临床意义和近期预后价值。方法: 将经冠状动脉造影（CAG）证实的71例冠心病患者，分为PCI组（51例）和对照组（20例），用电化学发光免疫分析法动态观察其血浆NT-proBNP浓度，分别比较PCI组术前、术后即刻、术后6 h、术后24 h和术后6个月血浆NT-proBNP水平的变化情况，以及随访期间PCI组与对照组患者血浆NT-proBNP浓度的变化。经超声心动图检测两组患者住院期间与术后6个月左心室舒张末期内径（LVEDD）和收缩末期内径（LVESD），室间隔（IVSW）与左室后壁厚度（LVPW），左室射血分数（LVEF），左室短轴缩短率（FS）及E/A比值以评价心功能。结果: PCI组术后6个月血浆Log NT-proBNP浓度［(2.0±0.5)ng/L］显著低于术前［(2.4±0.5)ng/L］水平（P<0.05）。对照组患者6个月后血浆Log NT-proBNP浓度［(2.5±0.6)ng/L］明显高于PCI组［(2.0±0.5)ng/L］（P<0.05）。比较超声心动图各项指标，PCI组患者术后6个月LVEF［(62±10)%］较术前［(64±10)%］有所下降（P<0.05）。结论: 冠心病患者行PCI术后6个月血浆NT-proBNP水平显著降低，提示血运重建与药物治疗联合可能优于单纯药物治疗，并且NT-proBNP对冠心病患者可能具有近期预后价值，可以指导临床医生早期干预，尽可能降低冠心病发病率和死亡率。

Changes of plasma NT-proBNP levels and their clinical significance in coronary heart disease patients 6 months after percutaneous coronary intervention

AIM: To observe the changes of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) levels in coronary heart disease(CHD) patients before and 6 months after percutaneous coronary intervention(PCI) and to explore their clinical significance and prognostic value.METHODS: Seventy one patients with coronary heart disease confirmed by coronary angiography(CAG) were divided into PCI group(51 cases) and control group(20 cases).Dynamic plasma NT-proBNP concentrations were observed by electrochemiluminescence ...