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B型利钠肽在急性冠脉综合征患者中的预后价值

Prognostic value of B-type natriuretic peptide in patients with acute coronary syndromes.

作者信息

Sun Tongwen, Wang Lexin, Zhang Yanzhou

机构信息

Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan Province, People's Republic of China.

出版信息

Arch Med Res. 2006 May;37(4):502-5. doi: 10.1016/j.arcmed.2005.09.007.

Abstract

BACKGROUND

B-type natriuretic peptide (BNP) is released from the cardiac ventricles in response to increased wall tension in patients with heart failure. The significance of blood BNP in predicting cardiac death in patients with acute coronary syndromes (ACS) in Chinese patients is yet to be established.

METHODS

Blood BNP concentration was measured in 106 ACS patients 1-3 days after onset of ischemic symptoms. Patients were followed-up for 6 months on mortality and other cardiovascular events.

RESULTS

During the follow-up, cardiac death occurred in 13 patients (non-survival group). Another 12 patients were hospitalized due to recurrence of ACS or heart failure. The mean blood BNP concentration in the non-survival group was significantly higher than that of the survival group (median 1132 vs. 116 ng/L, p <0.001). Multivariate logistic regression analysis incorporating age, gender, history of hypertension, diabetes, left ventricular ejection fraction, troponin I and therapeutic regimens indicated that BNP was an independent predictor of cardiac death in these patients (odds ratio = 21.19, 95% confidence interval 4.53-99.06, p <0.001).

CONCLUSIONS

BNP is a useful parameter in predicting cardiac death in Chinese patients with ACS.

摘要

背景

B型利钠肽(BNP)是在心力衰竭患者中,因心室壁张力增加而从心室释放的。血液BNP在中国急性冠状动脉综合征(ACS)患者中预测心脏性死亡的意义尚未明确。

方法

对106例缺血症状发作后1 - 3天的ACS患者测定血液BNP浓度。对患者进行6个月的随访,观察死亡率和其他心血管事件。

结果

随访期间,13例患者发生心脏性死亡(非存活组)。另有12例患者因ACS复发或心力衰竭住院。非存活组的平均血液BNP浓度显著高于存活组(中位数分别为1132 vs. 116 ng/L,p <0.001)。纳入年龄、性别、高血压病史、糖尿病、左心室射血分数、肌钙蛋白I和治疗方案的多因素逻辑回归分析表明,BNP是这些患者心脏性死亡的独立预测因子(比值比 = 21.19,95%置信区间4.53 - 99.06,p <0.001)。

结论

BNP是预测中国ACS患者心脏性死亡的有用参数。

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