急性心肌梗死患者血浆N-末端脑钠肽前体水平检测及其临床意义

目的探讨急性心肌梗死(AMI)患者住院早期血浆N-末端脑钠肽前体(NT-proBNP)水平与梗死面积、心功能及住院期心脏事件的关系。方法采用ELISA法测定41例AMI患者住院后48小时内血浆NT-proBNP水平,并与患者肌酸激酶(CK)和肌酸激酶同功酶(CK-MB)峰值浓度、左室射血分数(LVEF)、住院期主要不良心脏事件(MACE)对比分析。结果AMI患者血浆NT-proBNP水平明显高于正常对照组(699.44±386.28pg/ml vs 41.75±24.26pg/ml,P<0.001)。血浆NT-proBNP水平与CK、CK-MB峰值浓度呈正相关(r=0.817,P=0.001;r=0.772,P=0.001),与LVEF呈负相关(r=-0.661,P<0.01)。住院期发生MACE患者的血浆NT-proBNP水平明显高于未发生MACE者(971.50±367.01pg/ml vs 393.60±261.16pg/ml,P<0.001)。结论AMI患者血浆NT-proBNP水平与CK、CK-MB峰值呈正相关,与LVEF呈负相关。检测血浆NT-proBNP水平可预测AMI患者梗塞面积、心功能及住院期心血管事件。

Measurement of Serum NT-proBNP Level in Patients with Acute Myocardial Infarction and Its Clinical Significance

Objective To investigate the relationship among serum NT-proBNP level,myocardial infarct size,cardiac function and inhospital main adverse cardiac events(MACE) in patients with acute myocardiac infarction(AMI).Method The serum concentration of NT-proBNP in 41 patients with AMI and 39 healthy subjects were measured within 48h after admission by ELISA methods.The results were contrasted and analyzed with the peak concentrations of serum creatine kinase(CK) and its isoenzyme CK-MB,left ventricular ejection fraction(LVEF) as well as inhospital MACE.Results Serum NT-proBNP concentration in patients with AMI was significantly higher than that in healthy subjects(699.44±386.28pg/ml vs 41.75±24.26pg/ml,P<0.001).There was a positive correlation between serum NT-proBNP concentration and peak concentrations of CK(r=0.817,P=0.001) and CK-MB(r=0.772,P=0.001) in patients with AMI.There was a negative correlation between serum NTproBNP concentration and LVEF(r=-0.661,P<0.01).The serum NT-proBNP concentration in patients with inhospital MACE was significantly higher than that in patients without MACE(971.50±367.01pg/ml vs 393.60±261.16pg/ml,P<0.001).Conclusions Serum NT-proBNP concentration in patients with AMI is positively correlated with peak concentrations of CK and CK-MB,and is negatively correlated with LVEF.The measurement of serum NT-proBNP concentration might predict the myocardial infarct size,cardiac function and inhospital MACE rate in patients with AMI.