CAJ | 학술논문

目的探讨急性心肌梗死(AMI)患者血清脑钠肽(BNP)水平与近期预后的临床关系.方法将2008年1月至12月于我科住院的急性ST段抬高型心肌梗死患者99例按治疗方案分为直接经皮冠状动脉介入治疗(PCI)组61例,保守组38例.观察两组患者入院即刻、入院1 d、入院7 d 时血清BNP浓度的变化,并记录患者30 d内的主要不良心脏事件(MACE).结果入院即刻、1 d时两组患者血清BNP浓度差异无统计学意义(P＞0.05).入院7 d时PCI组患者血清BNP浓度低于保守组(P＜0.01),PCI组主要不良心脏事件发生率低于保守组(P＜0.05).对AMI者梗死后30 d主要不良心脏事件的危险因素进行logistic回归分析,显示患者入院7 d时血清BNP浓度是最主要的不良心脏事件预测因子(OR=1.026,95%CI 1.014-1.038,P＜0.01).所有患者30 d随访期间,发生主要不良心脏事件的患者入院7 d时血清BNP浓度高于未发生者(P＜0.01).结论 AMI患者入院7 d时的血清BNP水平可以作为判断近期预后的指标.
목적 탐토급성심기경사(AMI)환자혈청뇌납태(BNP)수평여근기예후적림상관계.방법 장2008년1월지12월우아과주원적급성ST단태고형심기경사환자99례안치료방안분위직접경피관상동맥개입치료(PCI)조61례,보수조38례.관찰량조환자입원즉각、입원1 d、입원7 d 시혈청BNP농도적변화,병기록환자30 d내적주요불양심장사건(MACE).결과 입원즉각、1 d시량조환자혈청BNP농도차이무통계학의의(P＞0.05).입원7 d시PCI조환자혈청BNP농도저우보수조(P＜0.01),PCI조주요불양심장사건발생솔저우보수조(P＜0.05).대AMI자경사후30 d주요불양심장사건적위험인소진행logistic회귀분석,현시환자입원7 d시혈청BNP농도시최주요적불양심장사건예측인자(OR=1.026,95%CI 1.014-1.038,P＜0.01).소유환자30 d수방기간,발생주요불양심장사건적환자입원7 d시혈청BNP농도고우미발생자(P＜0.01).결론 AMI환자입원7 d시적혈청BNP수평가이작위판단근기예후적지표.
Objective To investigate relationship between serum level of brain natriuretic peptide (BNP)and short-term prognosis in patients with acute myocardial infarction(AMI).Methods Ninetynine patients with AMl with elevated S-T segment in electrocardiogram admitted to the department of cardiology,the Fourth Hospital of Jilin University,Changchun during January to December 2008 were divided into two groups.one with percutaneous transluminal coronary angioplasty(PTCA)or pereutaneous coronary intervention(PCI)(61 eases)and the other without PTCA(38 cases)as controls.Their serum levels of BNP were measured at admission, and one day and seven days after admission,respectively,and their main adverse cardiac events(MACE)were followed-up and recorded for 30 days.Results No significant differenee in serum BNP level between the patients at admission and one day after admission was found(P＜0.01).Seven days after admission,serum BNP level in PCI group was significantly lower than that in controls(P＜0.01),and occurrence of MACE was significantly lower in PCI group than that in controls(P＜0.05).Logistic regression analysis indicated that serum BNP level in PCI group seven days after admission was the uppermost predictor for MACE in patients with AMI in one month after onset(OR=1.026,95%CI 1.014-1.038,P＜0.01).Serum BNP level was significantly higher in patients with MACE seven days after admission than that in those without it(P＜0.01)during 30-day followup.Conclusion Serum level of BNP seven days after admission is associated with their short-term prognosisfor patients with AMI.