左心室射血分数正常的急性ST段抬高型心肌梗死患者氨基末端B型利钠肽原水平与冠状动脉病变的关系

发布时间：2018-11-01 18:38

【摘要】：目的:探讨左心室射血分数(LVEF)正常的且无明显舒张性心力衰竭症状的急性ST段抬高型心肌梗死(STEMI)患者血浆氨基末端B型利钠肽原(NT-proBNP)浓度与冠状动脉(冠脉)狭窄程度、冠脉病变数量及左前降支病变的关系。方法:收集符合条件的STEMI患者280例,在入院24 h内检测其血浆NT-proBNP浓度,并对其根据Gensini评分系统评估冠脉病变狭窄严重程度,分为Gensini评分30分组(n=94),Gensini评分30~60分组(n=87),Gensini评分60分组(n=99);根据冠脉病变的数量分为单支病变组(n=78)、双支病变组(n=105)及三支病变组(n=97);根据罪犯血管是否为前降支分为前降支组(n=146)和非前降支组(n=134),对各组结果进行比较分析。结果:血浆NT-proBNP浓度Gensini评分60分组显著高于Gensini评分30分组和Gensini评分30~60分组,Gensini评分30~60分组显著高于Gensini评分30分组;冠脉病变的支数越多,血浆NT-proBNP浓度越高(pg/ml,336.90±176.70vs 608.70±331.20 vs 1176.70±492.50);前降支组血浆NT-proBNP浓度高于非前降支组(pg/ml,1199.40±725.00 vs607.40±244.20),上述比较差异均有统计学意义(P0.05)。血浆NT-proBNP浓度与Gensini积分Pearson相关分析显示两者呈正相关(r=0.278,P0.05)。结论:STEMI患者血浆NT-proBNP浓度与冠脉病变严重程度呈正相关,对其三支血管病变及前降支血管是否为罪犯血管具有一定预测价值,常规检测NT-proBNP浓度有助于STEMI患者的危险分层及临床诊疗。
[Abstract]:Objective: to investigate the plasma levels of amino-terminal B-type natriuretic peptide (NT-proBNP) and coronary shape in patients with acute ST segment elevation myocardial infarction (STEMI) with normal left ventricular ejection fraction (LVEF) and no obvious symptoms of diastolic heart failure. Degree of stenosis of artery (coronary artery), The relationship between the number of coronary artery lesions and the lesion of left anterior descending artery. Methods: 280 patients with STEMI were collected and their plasma NT-proBNP levels were measured within 24 hours after admission, and the severity of coronary stenosis was evaluated according to the Gensini scoring system. The patients were divided into 30 groups with Gensini score (n = 94). Gensini score was 30 to 60 groups (nnm87), Gensini score 60 groups (nm99); According to the number of coronary artery lesions, the patients were divided into three groups: single vessel lesion group (n = 78), double vessel lesion group (n = 105) and three vessel lesion group (n = 97). According to whether the culprit's blood vessel is anterior descending branch, it is divided into two groups: anterior descending branch group (nji146) and non-anterior descending branch group (nf134). The results of each group are compared and analyzed. Results: the Gensini score of plasma NT-proBNP concentration in 60 group was significantly higher than that of Gensini score 30 group and Gensini score 30 + 60 group. The Gensini score of 30 ~ 60 group was significantly higher than that of Gensini score 30 group. The more branches of coronary artery lesion, the higher the plasma NT-proBNP concentration (pg/ml,336.90 卤176.70vs 608.70 卤331.20 vs 1176.70 卤492.50). The plasma NT-proBNP concentration in the anterior descending branch group was higher than that in the non-anterior descending artery group (pg/ml,1199.40 卤725.00 vs607.40 卤244.20), and the above differences were statistically significant (P0.05). There was a positive correlation between plasma NT-proBNP concentration and Gensini integral Pearson (r = 0.278P 0.05). Conclusion: the plasma NT-proBNP concentration in patients with STEMI is positively correlated with the severity of coronary artery disease. Routine detection of NT-proBNP concentration is helpful to risk stratification and clinical diagnosis and treatment of STEMI patients.
【作者单位】：郑州大学第二附属医院心内科;
【分类号】：R542.22

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