摘要
目的探讨ACS患者血浆脑钠肽（BNP）和C-反应蛋白（CRP）水平与临床近期预后的关系。方法连续入选ACS患者66例，测定症状发作后24h内BNP和CRP水平，随访住院7d、14d病死率及主要心脏不良事件（MACE）（心源性猝死、再次心肌梗死、再发心绞痛、继发性心力衰竭）发生率。结果在ACS患者中BNP阳性（67％）多于阴性，且与BNP阴性组相比，BNP阳性组中，TNT和CRP数值均居高（P〈0．01），LVD增大，LVEF降低（P〈0．01），病死率及MACE阳性组亦明显多于阴性组。[多因素Logistic回归分析BNP（OR2．225，95％Ch 1．602～2．892）可独立预测ACS患者近期预后]。结论BNP和CRP能较好地对ACS患者进行危险分层，预测近期病死率和MACE发生率，并且各参数间有较好的相关性。
Objective To investigate the short-term prognostic value of plasma brain natriuretic peptlde（BNP） and C-reactive protein（CRP） in patients with acute coronary syndromes（ACS）, Methods 66 patients with ACS in our hospital were included in this study, plasma BNP and CRP were measured at a median of 24 hours from symptom onset, total mortality and the risk for major adverse cardiac events（MACE, incluing death, recurrent MI, recurrent angina, heart failure, readmission for any reason）at 7 days and 14 days was analyzed. Results The number of BNP positive（67%） in ACS patients where more than that of BNP negative; Compared with BNP negative patients, the cases of TNT and C RP positive were mole（P〈 0,01）, LVD were lalger and LVEF were less（P 〈 0.01） in BNP positive patients. Multivariate logistic regression analyses showed that the plasma BNP level predicted 7 days（r=0.7096, P〈 0.01） and 14 days（r=0.8315, P〈 0.01） incidence of MACE independent of other known prognostic factors such as age, gender, family heredity, hypercholesterolemia, diabetes, hypertension, smoking. Conclusion Both plasma BNP and CRP are good predictors for early mortality and MACE incidence in ACS patients.
出处
《中华临床医学杂志》
2007年第2期12-13,11,共3页
Chinese Journal of Clinical Practical Medicine
关键词
脑钠肽
C-反应蛋白
急性冠脉综合征
预后
Brain natriuretic peptide（BNP） C-reactive protein Acute coronary syndrome Prognosis
