CAJ | 학술논문

目的：研究联合检测N末端脑钠肽前体（NT-proBNP）及超敏肌钙蛋白（hs-CTNI）对急性非ST段抬高型冠状动脉综合征（NSTE-ACS）患者早期介入治疗以及危险分层的临床意义。方法选择245例NSTE-ACS行冠脉造影的患者，入院后即刻测定NT-proBNP及hs-CTNI ，据此分为Aa、Ab、Ba、Bb 4组。分别行冠脉介入治疗、冠脉搭桥手术及药物保守治疗，并进行6个月随访。结果 Aa组心功能大于1级患者明显高于Ba组，差异有统计学意义（P＜0．05）。Aa组发生左主干病变或左主干并3支病变共6例，明显高于其他3组。Bb组患者行冠脉介入手术率高于Aa组，差异有统计学意义（P＜0．05）。Bb组患者介入时间早于其他3组，差异无统计学意义（ P＞0．05）。半年随访，5例患者发生死亡，10例因顽固性心绞痛及心肌梗死再次行靶血管血运重建术。结论 NSTE-ACS患者NT-proBNP及hs-CTNI升高，与发生严重冠脉病变、临床预后差有密切关系，建议尽早行冠脉介入手术。
목적：연구연합검측N말단뇌납태전체（NT-proBNP）급초민기개단백（hs-CTNI）대급성비ST단태고형관상동맥종합정（NSTE-ACS）환자조기개입치료이급위험분층적림상의의。방법선택245례NSTE-ACS행관맥조영적환자，입원후즉각측정NT-proBNP급hs-CTNI ，거차분위Aa、Ab、Ba、Bb 4조。분별행관맥개입치료、관맥탑교수술급약물보수치료，병진행6개월수방。결과 Aa조심공능대우1급환자명현고우Ba조，차이유통계학의의（P＜0．05）。Aa조발생좌주간병변혹좌주간병3지병변공6례，명현고우기타3조。Bb조환자행관맥개입수술솔고우Aa조，차이유통계학의의（P＜0．05）。Bb조환자개입시간조우기타3조，차이무통계학의의（ P＞0．05）。반년수방，5례환자발생사망，10례인완고성심교통급심기경사재차행파혈관혈운중건술。결론 NSTE-ACS환자NT-proBNP급hs-CTNI승고，여발생엄중관맥병변、림상예후차유밀절관계，건의진조행관맥개입수술。
Objective To research the combined prognostic utility of NT-proBNP and hs-CTNI in NSTE-ACS risk stratification and early intervention therapy .Methods A total of 245 NSTE-ACS patients were divided to 4 groups(Aa ,Ab ,Ba ,Bb groups) ac-cording to immediate admission NT-proBNP and hs-CTNI .Patients were accepted percutaneous coronary intervention (PCI) ,coro-nary artery bypass grafting and conservative treatment were taken 6 months follow-up .Results The heart failure incidence of Aa group was significantly higher than Ba group(P<0 .05) .6 patients happened left main lesion or multivessel lesion in Aa group were obviously higher than other groups .The incidence of Bb group accepted PCI was obviously higher than Aa group (P<0 .05) .Bb group patients were accepted PCI earlier than other groups ,there was no significance(P>0 .05) .In 6 months follow-up ,5 patients died and 10 patients accepted revascularization again because of severe angina and AMI .Conclusion In NSTE-ACS patient ,NT-proBNP and hs-CTNI elevation was closely related with severe coronary lesions and worse prediction ,which could undergo early in-tervention therapy .