【摘要】 目的探讨血浆脑钠素(BNP)浓度与急性心肌梗死(AMI)预后的关系。方法血样BNP在心肌梗死急性期由110例患者获得,经在住院期间及经平均12个月的随访,观察心血管事件发生组与未发生组患者的血浆BNP浓度差异。结果AMI后血浆BNP浓度呈显著升高,发生心血管事件的患者BNP血浆浓度明显高于未发生者;急性期血浆BNP与心血管事件发生相关。结论AMI急性期血浆BNP浓度显著升高,提示心血管事件发生率高;BNP可作为后心血管事件的预测因子。更多还原

【Abstract】 Objective To evaluate the value of brain natriuretic peptide(BNP) in estimating risk stratification in patients with acute myocardial infarction(AMI) and to determine the relationship between BNP and adverse cardiac events after AMI.Methods The 135 subjects were selected into the study including 25 healthy subjects and 110 patients with a first AMI.The plasma concentrations of BNP were measured at two to four days after infarction in patients and healthy controls.Left ventricular function was evaluated by echocardiography with the parameters of left ventricular ejection function(LVEF) after 3 months.Patients were followed up at 12 months.The main outcome measures were heart failure,left remodeling mortality and other adverse cardiac events at one year.Results Plasma BNP concentrations in patients with AMI were much higher than those in the health control people[(416.7±208.0)ng/L versus (61.8±34.1)ng/L,P<0.01].The BNP count ranged from 5 to 2500ng/L in AMI patients.There was no association between the BNP count and mortality rate.The development of new congestive heart failure(CHF) was associated with a higher BNP count(P=0.02).The development of any of the clinical end point(death/CHF/shock) occurred move frequently in patients with a higher BNP count(13.8% for BNP count of <100ng/L,39.1% for BNP count of 100～200ng/L,43% for BNP count of 200～400ng/L 46.4% for BNP count of >400ng/L,P=0.019).Plasma BNP concentrations remained associated with the development of clinical end points in multivariable model that adjusted for potential confounding variables.Conclusion The results of the present study confirm that the elevated BNP count related to the risk stratification and prognosis in patients with AMI elevations in BNP count is associated with a higher incidence of new CHF and adverse clinical outcomes after AMI it could serve as s strong predictor for the subsequent development of poor outcomes in AMI patients.更多还原