【摘要】 目的通过观察急性心肌梗死(AM I)患者在发病第3天血清N末端B型钠尿肽前体(NT-proBNP)和C反应蛋白(CRP)的水平与AM I后3个月的左室舒张末期容积增加率之间的关系,寻找可用于预测AM I晚期左室重构的较理想指标。方法选择106例前壁、前间壁及前侧壁AM I患者,分别在发病第3天和3个月做超声心动图测定左室舒张末期容积的变化,将患者分为左室重构(LV remodeling,LVR)组及非左室重构组;采用电化学免疫发光法和免疫比浊法检测血清NT-proBNP和CRP水平。结果AM I后3个月左室舒张末期容积较基础值增加率与NT-proBNP水平的相关系数为0.706,P<0.001;与CRP的相关系数为0.596,P<0.05。血清NT-proBNP、CRP的ROC曲线下面积分别为0.892和0.825,二者曲线下面积无统计学差异。结论AM I患者血清NT-proBNP、CRP水平是预测晚期LVR的理想指标;AM I患者发病第3天的血清NT-proBNP水平与3个月时LVR呈正相关;血清NT-proBNP水平预测晚期LVR优于血清CRP水平。更多还原

【Abstract】 Objectives This study was designed to observe the correlation of the levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP) and high sensitivity C-reactive protein(hs-CRP) between the 3rd day after acute myocardial infarction(AMI) and after 3 months of left ventricular remodeling(LV remodeling) and to establish the predictive levels of NT-proBNP,hs-CRP for LV remodeling after AMI.Methods The blood samples from 106 patients with the first AMI and echocardiography were examined on the 3rd day and after 3 month.LV remodeling was estimated by the changes of left ventricular end-diastolic volume(LVEDV) during the 3rd day and after 3 month.Based on the change of LV remodeling,the 106 patients were divided into two groups:LV remodeling group(defined as the change rate of LVEDV more than 20%) and non-LV remodeling group.Results The correlation coefficients of the change of LVEDV were 0.706 for serum NT-pro BNP and 0.596 for hs-CRP.With a cutoff value of 0.20,the area under the ROC curve(AUCs) was(0.892) for NT-proBNP and 0.825 for hs-CRP.There was no statistically difference between NT-proBNP and hs-CRP.The ROC plot indicated that NT-proBNP was superior to hs-CRP for predicting LV remodeling.Conclusion The level of serum NT-proBNP appropriately reflects LV remodeling after AMI and shows more efficacious than the level of serum hs-CRP.The level of serum NT-proBNP on the 3rd day after AMI and LV remodeling were positively correlated with the level after 3 months.更多还原