【摘要】 目的评价氨基末端钠尿肽前体(NT-proBNP)对接受直接PCI的急性ST段抬高心肌梗死(STEMI)患者远期预后价值。方法顺序入选2008年12月～2010年6月胸痛发作<12 h并接受直接PCI的STEMI住院患者125例,根据随访期内有无心血管事件,分为事件组22例和非事件组103例,入院后12 h内测定NT-proBNP水平,随访1年内心血管事件的发生情况,并进行相关分析。结果与非事件组比较,事件组的NT-proBNP水平显著增高(P<0.05);在预测1年心血管事件中NT-proBNP的ROC曲线下面积为0.778。NT-proBNP阈值为729pmol/L时,Kaplan-Meier生存分析显示,NT-proBNP≤729 pmol/L患者1年无心血管事件生存率显著高于NT-proBNP>729 pmol/L者(P<0.01)。多元Cox回归分析显示,NT-proBNP、LVEF、肌钙蛋白Ⅰ峰值是患者远期发生心血管事件的独立预测因素。结论 NT-proBNP可以预测接受直接PCI急性STEMI患者的远期预后。更多还原

【Abstract】 Objective To assess the long-term effect of N-terminal pro-brain natriuretic peptide (NT-proBNP) on prognosis of patients with ST elevation myocardial infarction(STEMI) after primary PCI.Methods One hundred and twenty-five STEMI patients with chest pain who underwent PCI within 12 h after admission from December 2008 to June 2010 were divided into cardiac event group(n = 22) and non cardiac event group(n= 103) according to the occurrence of cardiac events during follow-up.NT-proBNP level was measured within 12 h after admission.The patients were followed up for 1 year,during which the incidence of cardiac events was observed.Results The NT-proBNP level was significantly higher in cardiac event group than in non cardiac event group(P<0.05).The area under ROC curves for NT-proBNP was 0.778.Kaplan-Meier analysis showed that the 1-year survival rate was significantly higher in free cardiac event patients with their NT-proBNP level<729 pmol/L than in those with their NT-proBNP level>729 pmol/L(P<0.01).Cox regression analysis showed that the peak NT-proBNP,LVEF and cTnI values were the independent predicting factors for the long-term outcomes of cardiovascular events in acute STEMI patients after primary PCI.Conclusion NT-proBNP can predict the long-term outcomes in acute STEMI patients after primary PCI.更多还原