【摘要】 目的探讨脑钠肽(BNP)与急性心肌梗死(AMI)近期预后的关系。方法使用BIOSITE Triage BNP干氏床旁快速检测方法对110例AMI患者入院1~3天的BNP水平进行测量,随访1个月,分为存活组和死亡组,另测量20例健康成人的血BNP水平做为对照。结果①AMI患者血BNP水平较对照组明显升高[(272.3±213.5)ng/L比(18.6±15.4)ng/L,t=7.21,P<0.01];②死亡组BNP水平明显高于存活组[(591.5±321.2)ng/L比(192.3±152.4)ng/L,t=5.26,P<0.01];③单因素分析表明,血BNP≥270 ng/L(中位数)和Killip分级Ⅱ级以上为1个月内心源性死亡的预测因素(均P<0.01);③Logistic回归分析表明,惟有血BNP≥650 ng/L(75%百分位数)为1个月内心源性死亡的独立预测因素(OR=9.24,95%可信区间3.26~35.42,P<0.01)。结论AMI患者血BNP水平明显升高,测量梗死早期的血BNP水平可用于AMI的危险分层及评价近期预后。更多还原

【Abstract】 Objective To investigate the relationship between brain natriuretic peptide(BNP) and short-term prognosis in patients with acute myocardial infarction(AMI).Methods A total of 110 patients with AMI were enrolled,their blood BNP concentration was measured with BIOSITE Triage BNP test,within 1-3 days after onset of ischemia symptoms,and then the patients were divided into two groups: survival group and non-survival group,according to the results of one mouth’s follow-up.and 20 health people whose blood BNP was measured served as control group.Results ① Blood BNP level in patients with AMI was significantly higher than that of control group [((272.3)±(213.5)) ng/L vs((18.6)±(15.4)) ng/L,t=(7.21),P<(0.01)].② Blood BNP concentration was significantly higher in non-survival group than that in survival group [(591.5)±(321.2)) ng/L vs((192.3)±(152.4)) ng/L,t=(5.26),P<(0.01))].③ Univariate analysis showed that,BNP≥(270 ng/L,median) and Killip Class(>Ⅱ) were prognostic factors of short-term cardiac death(<one month) in patients with AMI(both P<(0.01)).④Logistic regression analysis indicated that BNP ≥650 ng/L,(75% percentile) was the only independent predictor of one month cardiac death in patients with AMI(OR=(9.24),95% confidence interval(3.26)-(35.42),P<(0.01)).Conclusion Blood BNP increases in patients with AMI.Measuring the early stage of blood BNP concentration in patients with AMI can be evaluated for risk stratification and short-term prognosis.更多还原