摘要
目的探讨急性心肌梗死(AMI)患者入院即刻B型钠尿肽(BNP)与左心室射血分数(LVEF)、Killip分级及院内主要不良事件(MACE)的相关性。方法连续入选2010年1月至2011年6月就诊于北京友谊医院的308例AMI患者,按入院即刻血浆BNP水平分为3组,A组(BNP<100 pg/ml)116例,B组(BNP 100～450 pg/ml)125例,C组(BNP≥450 pg/ml)67例,根据Killip心功能分级分为I级、II及II级以上(包括III级及IV级),比较3组BNP水平患者Killip分级及左室射血分数的差异,并比较3组患者院内主要不良事件差异。结果 3组患者Killip分级构成比较,A组与B组无显著性差异,A组与C组、B组与C组均随着BNP水平升高,Killip II级以上比率明显增加,均具有统计学差异。3组患者随着BNP水平的升高,左心室射血分数逐渐下降,分别为(60.39±7.46)%、(57.96±8.08)%及(46.87±9.53)%,A组与C组、B组与C组之间两两比较均具有显著性差异。3组患者院内主要不良事件发生率分别为7.8%、6.4%和9.0%,组间比较无统计学差异。结论 AMI患者的入院即刻BNP水平与Killip分级严重程度呈正相关,与左心室射血分数呈负相关,与院内主要不良事件无显著相关性。
Objective To explore correlation between B-type natriuretic peptide（BNP） and left ventricular ejection fraction（LVEF）,Killip gradation and prognosis in patients with acute myocardial infarction.Methods Data of 308 consecutive patients with acute myocardial infarction（AMI） aged 18 to 75 years old admitted in Beijing Friendship Hospital for chest pain or discomfort during January 2010 to June 2011 were analyzed.All these patients were divided into three groups according to plasma level of BNP at admission;116 cases were in group A with plasma level of BNP lower than 100pg/ml,125 cases in group B with plasma level of BNP from 100 to 450 pg/ml and 67 cases in group C with plasma level higher than 450pg/ml.All these patients were classified according to Killip gradation into Killip I,Killip II and over-Killip II（including III and IV）,and the difference between LVEF and Killip grades was studied and the difference in major adverse cardiac events was compared among these three groups.Results The constituent ratios of Killip gradation in three groups were compared,Killip grade was elevated along with the step-up of plasma level of BNP,which has significant difference between group A and C,group B and C.LVEF was fall-off along with the step-up of BNP,and LVEF was fall-off step by step;it had no significant difference in major adverse cardiac events（MACE） among these three groups.Conclusion There is significantly negative correlation between plasma level of BNP on admission and LVEF in patients with acute myocardial infarction,and there is significantly positive correlation between plasma level of BNP and Killip gradation.However,there is no significant correlation between plasma level of BNP and MACE in hospital.
出处
《临床和实验医学杂志》
2012年第8期566-568,共3页
Journal of Clinical and Experimental Medicine
关键词
急性心肌梗死
B型钠尿肽
心功能
预后
Acute myocardial infarction
BNP
Left heart function
Prognosis
