【摘要】 目的探讨急性冠脉综合征(ACS)患者B型利钠肽(BNP)与全球急性冠状动脉事件注册(GRACE)评分间的关系。方法选取首都医科大学附属北京天坛医院2015年6月~2016年8月收治的104例ACS患者,根据GRACE评分将ACS患者分为低危(≤108分)、中危(109~140分)和高危(>140分)三组,分别检测各亚组BNP。将BNP水平从低到高按四分位数分成Q1~4组,计算各组GRACE评分及高危百分比。分析BNP与GRACE评分的相关性。使用受试者操作特征曲线(ROC)分析BNP水平及GRACE评分对ACS患者住院期间发生主要不良心脏事件(MACE)的曲线下面积,评估其预测价值。结果 ACS三个亚组中,高危组BNP高于中危组(P<0.05)和低危组(P<0.01),差异有统计学意义。Q4组GRACE评分及高危百分比高于Q4以下组(P<0.05)。相关性分析显示,BNP结果与GRACE评分呈正相关(r=0.448,P<0.01)。基线BNP水平及GRACE评分对ACS患者住院期间发生MACE的曲线下面积分别为0.677和0.745,差异有统计学意义(P<0.05)。结论 BNP水平和GRACE评分对ACS患者住院期间发生MACE有预测价值,可能成为ACS患者预后判断的重要指标。更多还原

【Abstract】 Objective To investigate the correlation between brain natriuretic peptide(BNP) level and global registry of acute coronary events(GRACE) risk score in patients with acute coronary syndrome(ACS). Methods One hundred and four patients with ACS admitted to Beijing Tiantan Hospital, Capital Medical University from June 2015 to August 2016 were selected. According to GRACE risk score, the patients with ACS were divided into low risk(GRACE: ≤108points), intermediate(GRACE: 109-140 points) and high(GRACE: >140 points) 3 groups, the levels of BNP in each subgroup were detected. According to the BNP level, the patients were divided into 4 groups from Q1 to Q4, and the GRACE scores and high-risk percentages were calculated. The correlation between BNP and GRACE score was analyzed. Receiver operating characteristic(ROC) was used to analyze the area under the curve of BNP level and GRACE risk score for major adverse cardiac events(MACE) in patients with ACS during hospitalization, and to evaluate its predictive value. Results Among the 3 subgroups of ACS, the BNP in high risk group was higher than the middle risk group(P <0.05) and the low risk group(P < 0.01), the differences were statistically significant. The GRACE score and high-risk percentage in group Q4 were higher than those in groups under Q4(P < 0.05). Correlation analysis showed that BNP results were positively correlated with GRACE score(r = 0.448, P < 0.01). The area under the curve of baseline BNP level and GRACE score for ACS patients during hospitalization was 0.677 and 0.745, respectively, the difference was statistically significant(P < 0.05). Conclusion Both BNP level and GRACE score can predict the occurrence of MACE in ACS patients during hospitalization, which may be an important prognostic indicator for ACS patients.更多还原