CAJ | 학술논문

目的：探讨血清N端B型脑钠肽（NT-pro BNP）水平检测在治疗急性冠脉综合征（ACS）中的临床意义。方法：抽选本院ICU收治的153例ACS患者，对其血清NT-pro BNP水平、冠脉病变程度Gensini评分以及左室射血分数（LVEF）进行检测和评定，并与同期93例健康体检者（对照组）和86例稳定性心绞痛患者（SAP组）进行对比研究；同时统计分析153例ACS患者经住院治疗前及治疗第7、15天血清NT-pro BNP水平变化。结果：（1）与对照组和SAP组相比，ACS患者的NT-pro BNP水平、冠脉病变程度Gensini评分明显升高，LVEF下降（P<0.05）；且SAP、UAP、AMI组中NT-pro BNP、Gensini评分呈递增式升高，LVEF递减式下降（P<0.05）。（2）153例ACS患者经治疗后，好转出院80例、心衰恶化39例、死亡34例。好转出院组患者在治疗第7天后血清NT-ProBNP显著下降（P<0.05），第7、15天均逐渐降低；而死亡组和心衰恶化组患者治疗后2个时点血清NT-ProBNP与治疗前相比呈逐渐升高趋势（P<0.05）。结论：血清NT-pro BNP有利于ACS的临床诊断及心功能评估，可作为评估 ACS治疗预后的一个重要监测指标。
목적：탐토혈청N단B형뇌납태（NT-pro BNP）수평검측재치료급성관맥종합정（ACS）중적림상의의。방법：추선본원ICU수치적153례ACS환자，대기혈청NT-pro BNP수평、관맥병변정도Gensini평분이급좌실사혈분수（LVEF）진행검측화평정，병여동기93례건강체검자（대조조）화86례은정성심교통환자（SAP조）진행대비연구；동시통계분석153례ACS환자경주원치료전급치료제7、15천혈청NT-pro BNP수평변화。결과：（1）여대조조화SAP조상비，ACS환자적NT-pro BNP수평、관맥병변정도Gensini평분명현승고，LVEF하강（P<0.05）；차SAP、UAP、AMI조중NT-pro BNP、Gensini평분정체증식승고，LVEF체감식하강（P<0.05）。（2）153례ACS환자경치료후，호전출원80례、심쇠악화39례、사망34례。호전출원조환자재치료제7천후혈청NT-ProBNP현저하강（P<0.05），제7、15천균축점강저；이사망조화심쇠악화조환자치료후2개시점혈청NT-ProBNP여치료전상비정축점승고추세（P<0.05）。결론：혈청NT-pro BNP유리우ACS적림상진단급심공능평고，가작위평고 ACS치료예후적일개중요감측지표。
Objective:To investigate the clinical determination significance of serum N terminal B type pro-B-type natriuretic peptide in the treatment of ACS.Method:153 cases of ACS patients with ICU in our hospital were selected,the serum NT-pro BNP level,Gensini coronary artery score and left ventricular ejection fraction(LVEF)were detected and evaluated,and were compared with 93 healthy subjects(control group)and 86 patients with stable angina pectoris(SAP group).At the same time,the serum NT-pro BNP level changes of the 153 patients with ACS before and after treatment in 7,15 days after were compered. Result:⑴Compared with the control group and SAP group,with NT-pro BNP levels, Gensini coronary artery score in the ACS patients were significantly increased,LVEF was decreased(P<0.05).And the SAP group,UAP group,AMI group,Gensini NT-pro BNP score was gradually increased,LVEF was gradually decreased (P<0.05).⑵In 153 ACS patients ,after the treatment,80 cases were discharged,34 cases were worsening heart failure, 39 cases were died.The serum NT ProBNP in discharged patients group was significantly decreased after 7 d treatment (P<0.05),and it was gradually reduced after 7,15 days.And serum NT ProBNP was gradually increasing trend in death group and heart failure group patients(P<0.05). Conclusion:Serum NT-pro BNP is evaluation of clinical diagnosis and heart function in favor of ACS,can be used as an important index to evaluate the treatment outcome of ACS monitoring.