CAJ | 학술논문

目的探讨血浆B型钠尿肽(BNP)快速床旁检测对急性冠脉综合征(ACS)危险分层和预后判断的意义.方法 ACS患者67例[ST段抬高心肌梗死(STEMI)组27例、非STEMI(NSTEMI)组20例、不稳定型心绞痛(UA)组20例]和稳定型心绞痛(SA)患者20例,入院24h内行床旁BNP快速测定,随访并对比分析30、90d内主要不良心脏事件(MACE).结果 ACS患者血浆BNP(559.59±535.16)(pg/ml)明显高于SA患者的(23.28±11.69)(pg/ml)(P<0.05);其中,STEMI组(1050.59±932.31)(pg/ml),明显高于NSTEMI组的(357.65±263.48)(pg/ml)和UA组的(98.69±96.99)(pg/ml)(P<0.05);冠脉3支病变组(972.54±224.05)(pg/ml),明显高于1支病变组的(249.29±192.10)(pg/ml)(P<0.01);BNP对30d内病死率预测的ROC曲线下面积(AUC)为0.89(95%CI为0.81～0.97)(P<0.05);当BNP>100pg/ml时其敏感性75%,特异性97%,准确性81%;3个月MACE预测的AUC为0.79(95%CI为0.67～0.90)(P<0.05),当BNP>100pg/ml时其敏感性84%,特异性69%,准确性64%.结论 ACS患者床旁快速检测BNP水平有助于ACS的危险分层和预后判断.
목적 탐토혈장B형납뇨태(BNP)쾌속상방검측대급성관맥종합정(ACS)위험분층화예후판단적의의.방법 ACS환자67례[ST단태고심기경사(STEMI)조27례、비STEMI(NSTEMI)조20례、불은정형심교통(UA)조20례]화은정형심교통(SA)환자20례,입원24h내행상방BNP쾌속측정,수방병대비분석30、90d내주요불양심장사건(MACE).결과 ACS환자혈장BNP(559.59±535.16)(pg/ml)명현고우SA환자적(23.28±11.69)(pg/ml)(P<0.05);기중,STEMI조(1050.59±932.31)(pg/ml),명현고우NSTEMI조적(357.65±263.48)(pg/ml)화UA조적(98.69±96.99)(pg/ml)(P<0.05);관맥3지병변조(972.54±224.05)(pg/ml),명현고우1지병변조적(249.29±192.10)(pg/ml)(P<0.01);BNP대30d내병사솔예측적ROC곡선하면적(AUC)위0.89(95%CI위0.81～0.97)(P<0.05);당BNP>100pg/ml시기민감성75%,특이성97%,준학성81%;3개월MACE예측적AUC위0.79(95%CI위0.67～0.90)(P<0.05),당BNP>100pg/ml시기민감성84%,특이성69%,준학성64%.결론 ACS환자상방쾌속검측BNP수평유조우ACS적위험분층화예후판단.