N-端脑利钠肽前体测定对急性冠脉综合征早期诊断及危险分层的临床意义

目的:分析急性冠脉综合征(ACS)患者N-端脑利钠肽前体(NT-proBNP)与肌钙蛋白(cTnI)的相关性,探讨NT-proBNP对ACS早期诊断及危险分层的临床意义。方法:采用免疫定量分析仪及配套试剂测定ACS患者血浆NT-proBNP与cTnI,比较ST段抬高型心肌梗死(STEMI)组、非ST段抬高型心肌梗死(NSTEMI)组不稳定型心绞痛(UA)组及正常对照组NT-proBNP浓度的变化,分析NT-proBNP与cTnI的相关性。结果:血浆NT-proBNP浓度STEMI、NSTEMI组高于UA组,UA组高于正常对照组,差异均有统计学意义(P<0.05)。按冠状动脉病变分组,NT-proBNP浓度3支病变组高于1支病变组,差异有统计学意义(P<0.05)。ACS患者cTnI浓度与NT-proBNP浓度呈正相关。结论:NT-proBNP水平测定可用于ACS患者的早期诊断及危险分层,对临床制定治疗干预策略可能有一定参考价值。

Clinical significance of NT-proBNP in the early diagnosis and risk stratification of acute coronary syndrome

Objective: To analyze the N-terminal brain natriuretic peptide(NT-proBNP) in acute coronary syndrome(ACS) patients and the troponin correlation of NT-proBNP in early diagnosis of ACS and risk stratification of clinical significance.Methods: By using immunohistochemical quantitative analyzer and supporting reagent the plasma NT-proBNP and cTnI of ACS patients concentration was detected.The concentration changes of NT-proBNP in ST-segment elevation myocardial infarction(STEMI) group,Non-ST-segment elevation myocardial infarction(NSTEMI) group,unstable angina(UA) group and control group were compared.The correlation between the NT-proBNP and cTnI was analyzed.Results: NT-proBNP concentration in STEMI group and NSTEMI group was significantly higher than that in UA group(P<0.05),and that in UA group was higher than in control group(P<0.05).NT-proBNP concentration of 3-vessel disease patients was higher than a vessel disease patients(P<0.05).The cTnI concentrations and NT-proBNP concpatients in ACS patients were positively correlated.Conclusion: NT-proBNP level in patients with ACS can be used for early diagnosis and risk stratification for clinical development of therapeutic intervention strategies,and may have some clinical reference value.