BNP对行急诊冠状动脉介入治疗患者预后价值的应用

目的:观察ST段抬高的急性心肌梗死(STEAMI)患者接受急诊直接冠状动脉介入治疗(PCI)后的脑利钠肽(BNP)水平对长期预后价值的应用。方法:连续入选2009年1月～2011年1月之间,发病后12小时之内接受急诊直接PCI治疗的ST段抬高的急性心肌梗死患者184例,采用荧光免疫抗原抗体结合方法测定发病后24小时血浆BNP水平。根据BNP浓度分为3组:A组<100pg/mL,B组100～400pg/mL,C组>400pg/mL。收集住院期间的临床资料,并随访1年。结果:①冠状动脉造影结果中B组、C组多支血管病变比例明显高于A组(P<0.01)。②1年内病死率C组明显高于A、B组(P<0.01),进行多因素logistic回归分析,血浆BNP浓度是AMI后1年病死率的独立预测因子。结论:接受急诊直接冠状动脉介入治疗的ST段抬高的急性心肌梗死患者的早期血浆脑利钠肽水平可作为1年后病死率的预测因子。

Prognostic Value Application of Brain Natriuretic Peptide in Patients with Acute Myocardial Infarction Treated with Priary Percutaneous Coronary Intervention

Objective:To evaluate the value of brain natriu retic peptide(BNP)on predicting long-term mortality after hospital discharge in patients with ST elevated acute myocardial infarction(STEAMI)treated with primary percutaneous coronary in tervention (PCI).Methods:From January 2009 to January 2011,consecutive 184 patients with STEAMI,successfully perfused by primary PCI within 12 hours were included in this study.BN P plasma concen tration levels were measured by fluorescence immunoassay at 24h from onset,and patients were divided in to 3 groups:groupA(<100pg/ml);groupB(100～400pg/m l);groupC(>400pg/ml).The clinical data was collected during hospitalization and all patients were followed up for 12 months.Results:①Compared with group A,patients in group B,C had more mult-vessel diseases(P<0.01).②There was sign ificantly higher 1-year mortality in group C compared with group A,B(P<0.01).By multivariate analysis,BNP plasma concentration was an independent predictor of long-term mortality(P< 0.05).Conclusions:Earlyphase BNP plasm a concentrations after successful PCI in patients with ST elevated acute myocardial infarction maybe a strong predictor for 1-year mortality.