急性冠脉综合征患者血浆N末端脑钠肽的变化及其预后价值

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1、急性冠脉综合征患者血浆N末端脑钠肽的变化及其预后价值硕士生姓名：指导教师：指导小组：专业名称：摘要刘倩倩刘俊教授刘俊教授内科学目的：探讨血浆N末端脑钠肽前体(NT．proBNP)在急性冠状动脉综合征(ACS)患者发病不同时期的水平变化及其预后价值。方法：采用ELISA法测定99例ACS患者住院后24d,时以内及1周后血浆NT-proBNP水平，并随访1个月，观察随访期主要不良心脏事件(MACE)。结果：ACS患者住院24小时以内和l周时血浆NT-proBNP水平分别为(1120．70+2064．90)pg／ml和(241．01士309．72)pg／ml

2、，中位数值分别为351．60pg／ml和103．90pg／ml。99例ACS患者血浆NT-proBNP水平均升高，STEMI组和NSTEMI组明显高于不稳定型心绞痛组(P<0．05)，且入院24tJ、时以内血浆NT-proBNP高于中位数值患者的随访期MACE发生率明显高于NT-proBNP水平低于中位数值者。多元Logistic回归分析显示，血浆NT-proBNP水平与ACS患者1个月随访期内MACE发生率独立相关(P=0．00l，OR=l3．74，95％C12．73～68．97)。结论：血浆NT．proBNP水平是ACS患者1个月随访期内MACE发

3、生的独立预测因素。关键词：急性冠状动脉综合征N末端钠尿肽前体主要不良心脏事件预后RelationshipbetweenthechangesofserumN—terminalprobrainnatriureticpeptidelevelsandthevalueofshort—termprognosisinpatientswithacutecoronarysyndromeMasterdegreecandidate．：LiuQianqianSupervisor：ProfessorLiuJunVice—supervisor：ProfessorLiuJunMaj

4、or：InternalmedicineAbstract0bjective：ToevaluatethecorrelationsofserumN-terminalprobrainnatriureticpeptide(NT-proBNP)levelsandprognosisinpatientswithacutemyocardialsyndrQmes(ACS)during1-monthfollow·up．Methods：SerumNT-proBNPconcentrationsweremeasuredbyELISAmethodwithin24hafteradmi

5、ssionand1weekonadmissionin99patientswithACS．Thepatientswerefollowedupfor1monthandthemainadversecardiovascularevents(MACE)wereobservedandrecorded．Results：SerumNT-proBNPlevelsincreasedin99patientswithACS．Comparedwiththatinpatientswithunstableanginasubjects，SerumNT-proBNPlevelswith

6、STEMIandNSTEMIsubjectswassignificantlyhigh(P<0．05)．ThemeanvalueofNT-proBNPconcentrationswithin24hafteradmis-sionand1weekonadmissioninpatientswithACSwas1120．70士2064．90pg／mland241．01+309．72pg／mlseparately，themediumvaluewas351．60pg／mland103．90pg／mlseparately．TheincidenceofMACEwasin

7、creasedinpatientswhoseserumNT-proBNPconcentrationwashigherthanthemediamwithin24hafteradmission．Multivariatelogisticregres-sionanalyisisrevealedthatNT-plroBNPConcentrationwascorrelatedwiththeincidenceofMACEduringfollow．upindependently(OR=13．74，95％C12．73"-,68．97，P=0．001)Conclusion

8、s：SerumNT-proBNPlevelisaindependentpredictorfor