ACS患者血浆NT-proBNP水平变化及对PCI治疗预后的临床意义

目的：为了研究急性冠脉综合征（ACS）患者血浆N氨基末端脑钠肽前体（NT-proBNP）水平变化及对经皮冠状动脉介入术（PCI）治疗预后的临床意义。方法：荧光免疫分析156例ACS患者（包括84例AMI和72例UAP）和30例SAP患者以及42例正常对照组的血浆NT-proBNP水平并进行了比较分析。结果：在156例ACS患者中,84例AMI组（P〈0.01）和72例UAP组（P〈0.05）患者血浆NT-proBNP水平显著高于30例SAP组和42例正常对照组,30例SAP组较之42例正常对照组无明显差异（P〉0.05）。156例ACS患者随疾病的严重程度、UAP分级和冠脉病变支数,血浆NT-proBNP水平增加。156例ACS患者PCI治疗后,44例心血管事件组血浆NT-proBNP水平明显高于112例无心血管事件组（P〈0.01）,并与LVEDD呈正相关,与LVEF呈负相关,故血浆NT-proBNP水平是随访、考核疗效的有效指标。结论：血浆NT-proBNP的测定是ACS患者诊断、疾病严重程度判断和PCI疗效考核的有效工具。

Clinical and Prognostic Significance of Changes of Plasma NT-proBNP Levels inPatients with ACS Undergone PCI Treatment

Objective To study the clinical and prognostic significance of changes of plasma NT-proBNP levels in patients with acute coronary syndrome （ACS） undergone percutaneous coronary intervention （PCI） treatment.Methods Plasma NT-proBNP levels were measured with flurorescent immunoassay in 156 patients with ACS （AMI n = 84,unstable angina pectoris UAP n = 72） ,30 patients with stable angina pectoris （SAP） and 42 controls.Results The plasma NT-pro BNP levels in all the patients with ACS were significantly higher than those in patients with SAP and controls,however,the levels in patients with SAP were not much different from those in controls （P〈 0.05） .Among the patients with ACS,the plasma levels of NT-pro BNP increased along with increase of severity of the disease process,UAP Braunwald grading as well as humber of stenosed coronary artery branches.All the 156 ACS patients underwent PCI,and 44 of them developed new cardiovascular events within 30 days.The plasma NT-proBNP levels in the 44 patients were significantly higher than those in the rest 112 patients （P〈 0.01） .Plasma NT-proBNP levels were significantly positively correlated with LVEDD （r = 0.8132,P〈 0.01） and significantly negatively correlated with LVEF （r =-0.7564,P〈 0.01） .Conclusion Determination of changes of plasma NT-pro BNP levels in patients with ACS was very helpful for assessment of severity of disease and prediction of outcomes of PCI.