急性心肌梗死合并糖尿病患者血浆B型钠尿肽水平预测主要心脏不良事件的价值

目的探讨合并糖尿病的急性心肌梗死(AMI)患者的血浆N末端前体B型钠尿肽(NT-proBNP)水平对主要心脏不良事件(MACE)的预测价值。方法选择冠心病(AMI)患者139例,根据诊断分为AMI合并糖尿病组(合并组)73例,AMI组66例,另选择同期住院的非冠心病患者64例作为对照组,采用化学发光法检测血浆NT-proBNP水平,分析NT-proBNP判断6个月后MACE的发生率。结果合并组血浆NT-proBNP水平显著高于AMI组和对照组(796.7±256.4)ng/L vs(642.5±231.5)ng/L和(89.6±103.3)ng/L,P<0.05,P<0.01],血浆NT-proBNP水平与冠状动脉造影Gensini评分呈正相关(r=0.726,P<0.01),合并组NT-proBNP>920ng/L的患者6个月MACE发生率较≤920ng/L者明显增高(60.0%vs 15.2%,P<0.01)。结论血浆NT-proBNP水平与AMI合并糖尿病患者的病情严重程度有一定的相关性。

Value of NT-proBNP for predicting major adverse cardiac events in acute myocardial infarction patients with diabetes mellitus

Objective To study the value of NT-proBNP for predicting the major adverse cardiac events(MACE)in acute myocardial infarction(AMI)patients with diabetes mellitus(DM).Methods One hundred and thirty-nine patients with coronary heart disease(CHD)were divided into AMI plus DM group(n=73)and AMI group(n=66),and 64non-CHD patients served as a ontrol group in this study.Their plasma NT-proBNP levels were measured.The incidence of MACE was analyzed in the patients 6months after treatment.Results The plasma NT-probing level was significantly higher in AMI plus DM group than in AMI group and control group(P<0.05,P< 0.01),and positively related with the Gensini score(r=0.726,P<0.01).The incidence of MACE was significantly higher in AMI plus DM patients with their plasma NT-proBNP level>920ng/L than in those with with their plasma NT-proBNP level≤920ng/L 6months after treatment(P< 0.01).Conclusion Plasma NT-proBNP level is related with AMI plus DM.