陆峰，王连生，李春坚，张定国，杨志健，周蕾

引用本文： 陆峰，王连生，李春坚，张定国，杨志健，周蕾.不稳定性冠心病病人血浆NT-proBNP水平与冠状动脉病变严重程度的关系探讨[J].中西医结合心脑血管病杂志,2020,18(1):29-33

摘要： 目的探讨不稳定性冠心病病人参照SYNTAX评分原则确定的冠状动脉病变严重程度（SCAD）和急性冠状动脉事件（ACE）等影响因素与血浆N末端脑钠肽前体（NT-proBNP）水平的关系，分析脑钠肽（BNP）对不稳定性冠心病冠状动脉病变诊断和病人预后的预测价值。方法选取2013年1月—2016年6月住院行冠状动脉造影（CAG）并完成术前血浆NT-proBNP检测的不稳定型心绞痛和发生ACE的急性冠脉综合征病人共1 293例，参考SYNTAX评分原则确定SCAD，通过Logistic回归来回顾性分析各影响因素和血浆NT-proBNP水平的相关性。结果不稳定性冠心病病人参照SYNTAX评分的SCAD和ACE都独立于其他危险因素与NT-proBNP水平呈正相关，在NT-proBNP界值1 022 pg/mL的界值水平：ORSCAD＝2.294，P＝0.008；ORACE＝3.122，P＝0.001。分层和亚组分析的结果也是一致的。结论不稳定性冠心病病人通过CAG并参照SYNTAX评分原则确定的SCAD和ACE都独立于其他危险因素与病人血浆BNP水平有密切关系。不稳定性冠心病病人冠状动脉病变越严重血浆BNP水平越异常升高。持续高BNP状态可以揭示心脏功能恶化并能够预测不良心脏事件发生。

关键词： 不稳定性冠心病；N末端脑钠肽前体；冠状动脉病变；严重程度；急性冠状动脉事件；脑钠肽

作者简介： 1.苏州大学附属第一医院广慈分院（江苏苏州215000）；2.南京医科大学第一临床医学院（南京 210029） 周蕾，E-mail：zhoulei@njmu.edu.cn

课题： 国家自然基金面上项目（No.81270255）

LU Feng,WANG Liansheng ,LI Chunjian,ZHANG Dingguo,YANG Zhijian,ZHOU Lei

Abstract Objective To analyze the correlations between severity of coronary artery disease(SCAD),acute coronary events (ACE)and plasma N-terminal pro Brain Natriuretic Peptide (NT-proBNP) concentration in hospitalized unstable coronary artery disease patients.MethodsFrom January 2013 to June 2016,one thousand two hundred and ninety-three unstable coronary artery disease patients who had examined coronary angiography were selected,including unstable angina and acute coronary syndrome with acute coronary events.The severity of coronary artery disease was estimated referring to SYNTAX score.The correlation between the influence factors and plasma NT-proBNP level was analyzed by logistic regression.ResultsSeverity of coronary artery disease referring to SYNTAX score and acute coronary events both correlated positively well with plasma NT-proBMP level.The NT-proBNP critical value was 1 022 pg/mL,ORSCAD＝2.294,P＝0.008;OR ACE＝3.122 ,P＝0.001.Further stratification and subgroup analyses also showed the unanimous outcomes.ConclusionSeverity of coronary artery disease referring to SYNTAX score and acute coronary events both correlate independently well with NT-proBNP level in hospitalized unstable CAD patients.The more serious the coronary lesions means the more abnormally elevated plasma BNP level.High BNP level may sngest deteriorative cardiac function and terrible prognosis.

Keywords unstable coronary artery disease;N-T pro Brain natriuretic pepide;coronary artery disease;severity;acute coronary events;Brain Natriuretic Pepide

阅读全文：0

免费浏览,查看全文　 html版　 　PDF版
阅读此文章需pdf阅读器 下载Pdf格式阅读器