摘要
目的探讨老年人血浆N端B型脑利钠肽前体（NT—proBNP）水平与急性ST段抬高心肌梗死（AMI）的梗死部及预后的关系。方法回顾性的分析宁波市第一医院心血管内科2012年5月至2014年4月住院的137例发病24h内ST段抬高AMI的老年患者（AMI组）和40例同时期在我院体检的老年健康人（对照组）的临床资料，采用酶联免疫吸附试验检测两组患者血浆NT—proBNP的水平并进行比较；AMI组患者根据AMI的部位不同分为前壁梗死组（44例）、前侧壁梗死组（21例）、前间壁梗死组（18例）、下壁梗死组（54例），探讨不同梗死部位老年人血浆NT—proBNP水平的变化；随访患者30d和1年的主要心血管事件（MACE）的发生率和病死率，探讨血浆NT—proBNP水平与AMI预后的关系。结果AMI组血浆NT—proBNP水平（1406．2±1322．5）ng／L较对照组（63．7±18．5）ng／L升高（P〈0．01）。心肌梗死部位不同血浆NT—proBNP水平由高至低依次为前壁梗死组、前侧壁梗死组、前间壁梗死组、下壁梗死组（P〈0．05）。30d内死亡患者NT—proBNP水平高于存活患者（P〈0．05），MACE发生患者高于未发生患者（P〈0．05）；1年内发生死亡患者与存活患者NT—proBNP水平比较，差异无统计学意义（P〉0．05），MACE发生患者较未发生患者升高（P〈0．05）。结论老年急性ST段抬高的心肌梗死患者的血浆NT—proBNP水平与梗死部位相关，前壁心梗最高，且对MACE有预测作用。
Objective To explore the relationship between plasma N-terminal pro Btype natriuretic peptide （NT-proBNP） level and the location and prognosis of acute ST-segment elevation myocardial infarction （STEMI） in elderly people. Methods From May 2012 to April 2014, the 137 elderly patients （aged≥60 years） with acute STEMI within 24 h after symptoms onset admitted in cardiovascular department of Ningbo First Hospital were selected as acute myocardial infarction group （AMI group）, and 40 elderly healthy people （age≥60 years） as control group. The plasma NT- proBNP levels were detected by enzyme linked immunosorbent assay（ELISA）, and compared between the two groups. The patients in AMI group were classified into four subgroups： anterior AMI group （A group, n=44）, anterolateral AMI group （B group, n=21）, anterior septal AMI group （C group, n=18） and inferior AMI group （D group, n=54）, and the changes of plasma NT-proBNP levels in different infarction location were explored. Meanwhile, all patients were followed up for 30 days and 1 year to observe major adverse cardiac events （MACEs） and mortality rate, then to explore the relationship between plasma NT-proBNP level and prognosis in elderly people with STEMI. Results The plasma NT-proBNP levels were significantly higher in AMI group than in control group [（1 406.2±1 322.5）ng/L vs. （63.7±18.5） ng/L, P〈0.01]. The changes of plasma NT-proBNP levels in high-to-low sequence were from A group to B group to C group to D group and to control group （P〈0.05）. At 30 days, the plasma NT-proBNP levels were higher in death group than in survival group （P〈0.05）, and were higher in MACE group than in non-MACE group （P〈0.05）. At one year, there were no significant differences in plasma NT-proBNP levels between death group and survival group （ P〉0.05）, and the plasma NT-proBNP levels were higher in MACE group than in non-MACE group （P〈 0.05）. Conclusions In elderly STEMI patients, there is a correlat
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2016年第1期13-15,共3页
Chinese Journal of Geriatrics
关键词
心肌梗死
利钠肽
脑
预后
Acute Myocardial infarction
Natriuretic plasma, brain
Prognosis
