摘要
目的分析急性非ST段抬高型心肌梗死(NSTEMI)患者经皮冠状动脉介入治疗(PCI)术后血浆N末端脑钠肽前体(NT-proBNP)水平对其生存的预测价值,为临床提供参考依据,以提高患者生存率。方法将2019年9月至2021年3月于首都医科大学宣武医院急诊科首诊的120例急性非ST段抬高型心肌梗死患者纳为研究对象,患者均行PCI后,根据不同手术时机分为择期组(53例)和急诊组(67例),两组于术前、术后7 d均行NT-proBNP水平检测和心脏超声射血分数(EF)测定并比较其结果。急诊组患者随访6个月,根据心血管事件发生情况将患者又分为事件组(15例)与非事件组(52例)两个亚组,比较两组出院时与随访6个月时的NT-proBNP水平与EF指标;运用Pearson相关性分析法与Logistic多元回归分析NT-proBNP水平与心血管事件的相关性。结果急诊组患者术前的NT-proBNP水平低于择期组(P<0.05),两组术后7 d的NT-proBNP水平均降低(P<0.05),急诊组术后7 d的NT-proBNP水平低于择期组(P<0.05),两组术前、术后7 d的EF比较,差异无统计学意义(P>0.05)。急诊组中两亚组患者随访6个月时的NT-proBNP水平与出院时相比,在事件组升高(P<0.05),在非事件组降低(P<0.05);非事件组随访6个月时的NT-proBNP水平低于事件组(P<0.05),EF高于事件组(P<0.05)。Pearson相关性分析显示,血浆NT-proBNP水平与心血管事件呈正相关性(r=0.802,P=0.000),Logistic多元回归分析显示,NT-proBNP是心血管事件的独立危险因素(P<0.05)。结论急诊PCI可降低急性非ST段抬高型心肌梗死患者NT-proBNP水平,NT-proBNP水平与急诊PCI术后心血管事件之间存在相关性,对患者生存预测具有一定指导作用。
Objective To analyze the predictive value of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)to survival in patients with acute non-ST-segment elevation myocardial infarction(NSTEMI)after percutaneous coronary intervention(PCI),and to provide reference evidence for improving patient’s survival rate.Methods The patients with acute NSTEMI(n=120)were chosen from Xuanwu Hospital of Capital Medical University from Sept.2019 to Mar.2021.After received PCI,all patients were divided into selective group(n=53)and emergency group(n=67).The level of NT-proBNP and ejection fraction(EF)were detected and compared in 2 groups before PCI and after PCI for 7 d.The emergency group was followed up for 6 months and divided,according to occurrence of cardiovascular events,into event subgroup(n=15)and non-event subgroup(n=52).The level of NT-proBNP and EF index were compared in 2 groups at time of discharge and after follow-up for 6 months.The correlation between NT-proBNP and cardiovascular events was analyzed by using Pearson correlation analysis and multivariate Logistic regression analysis.Results The level of NT-proBNP was lower in emergency group than that in selective group before PCI(P<0.05),and all decreased in 2 groups after PCI fro 7 d(P<0.05).The level of NT-proBNP was lower in emergency group than that in selective group after PCI fro 7 d(P<0.05).The difference in EF had no statistical difference in 2 groups before PCI and after PCI for 7 d(P>0.05).The level of NT-proBNP increased in event subgroup,decreased in non-event subgroup after 6-month follow-up(P<0.05).The level of NT-proBNP was lower(P<0.05)and EF was higher(P<0.05)in non-event subgroup than those in event subgroup after 6-month follow-up.The results of Pearson correlation analysis showed that NT-proBNP level was positively correlated to cardiovascular events(r=0.802,P=0.000).The results of multivariate Logistic regression analysis showed that NT-proBNP level was an independent risk factor of cardiovascular events(P<0.05).Conclusion Emergency PCI can
作者
闫博
王春源
李健
邢绣荣
Yan Bo;Wang Chunyuan;Li Jian;Xing Xiurong(Department of Emergency,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;不详)
出处
《中国循证心血管医学杂志》
2022年第7期833-835,838,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
北京市属医院科研培育计划(PX2019028)
首都医科大学宣武医院2018年度院级课题(XWJL-2018038)。
关键词
急性非ST段抬高型心肌梗死
PCI
NT-PROBNP
生存
Acute non-ST-segment elevation myocardial infarction
Percutaneous coronary intervention
N-terminal pro-brain natriuretic peptide
Survival
