CAJ | 학술논문

目的：探讨不同部位ST段抬高型心肌梗死（STEMI）患者脑钠肽（BNP）水平的差异及BNP水平与近期预后的关系。方法纳入2012年6月~2013年6月徐州市中心医院心内科首次入院接受冠状动脉造影检查的STEMI患者124例，结合心电图及冠脉造影（CAG）结果，将患者分为三组，即前壁、高侧壁心肌梗死组53例（A组），下、后壁心肌梗死组41例（B组），右心室心肌梗死组30例（C组），同期纳入CAG正常患者30例作为对照组（D组），比较各组BNP水平差异。将所有患者再按照BNP水平分为：BNP正常组（＜100 ng/ml）36例、轻度升高组（100～400 ng/ml）61例、显著升高组（≥400 ng/ml）27例，比较各组6个月内MACE事件（继发心力衰竭、严重心律失常、梗死后心绞痛、再发心肌梗死、心源性死亡）发生率的差异。结果 A组、B组、C组、D组患者，BNP水平呈现逐渐降低趋势[分别为：（305.17±112.63）pg/ml、（201.38±72.54）pg/ml、（157.43±79.18）pg/ml、（39.49±15.07）pg/ml]，各组间差异均有统计学意义（P＜0.05）；除BNP正常组和轻度组心源性死亡率无统计学差异（P＞0.05），其余不同BNP水平组间MACE事件发生率比较，差异均有统计学意义（P＜0.05），MACE事件发生率在BNP正常组、轻度组、显著升高组呈现增高趋势。结论 BNP水平可作为临床上评价STEMI患者近期预后危险程度的指标。
목적：탐토불동부위ST단태고형심기경사（STEMI）환자뇌납태（BNP）수평적차이급BNP수평여근기예후적관계。방법납입2012년6월~2013년6월서주시중심의원심내과수차입원접수관상동맥조영검사적STEMI환자124례，결합심전도급관맥조영（CAG）결과，장환자분위삼조，즉전벽、고측벽심기경사조53례（A조），하、후벽심기경사조41례（B조），우심실심기경사조30례（C조），동기납입CAG정상환자30례작위대조조（D조），비교각조BNP수평차이。장소유환자재안조BNP수평분위：BNP정상조（＜100 ng/ml）36례、경도승고조（100～400 ng/ml）61례、현저승고조（≥400 ng/ml）27례，비교각조6개월내MACE사건（계발심력쇠갈、엄중심률실상、경사후심교통、재발심기경사、심원성사망）발생솔적차이。결과 A조、B조、C조、D조환자，BNP수평정현축점강저추세[분별위：（305.17±112.63）pg/ml、（201.38±72.54）pg/ml、（157.43±79.18）pg/ml、（39.49±15.07）pg/ml]，각조간차이균유통계학의의（P＜0.05）；제BNP정상조화경도조심원성사망솔무통계학차이（P＞0.05），기여불동BNP수평조간MACE사건발생솔비교，차이균유통계학의의（P＜0.05），MACE사건발생솔재BNP정상조、경도조、현저승고조정현증고추세。결론 BNP수평가작위림상상평개STEMI환자근기예후위험정도적지표。
Objective To investigate the difference in the level of B-type natriuretic peptide (BNP) and relationship between BNP and short-term prognosis in the patients with ST-segment elevation myocardial infarction (STEMI). Methods The patients with STEMI [n=124, firstly being hospitalized and accepting coronary angiography (CAG)] were chosen from the Central Hospital of Xuzhou City, and according to the outcomes of ECG and CAG, they were divided into group A (n=53), group B (n=41) and group C (n=30), and other patients with normal CAG (n=30) were chosen as group D (control group). The level of BNP was compared among all groups. All patients were divided again, according to the level of BNP, into normal BNP group (<100 ng/mL, n=36), mild-higher BNP group (100-400 ng/mL, n=61 group) and marked-higher BNP group (≥400 ng/mL, n=27). The incidence of major adverse cardiovascular events (MACE, including secondary heart failure, severe arrhythmia, post-infarction angina, relapse myocardial infarction and cardiac death) was compared among all groups within 6 months. Results The level of BNP showed a gradual decreasing trend [(305.17±112.63) pg/mL, (201.38±72.54) pg/mL, (157.43±79.18) pg/mL, (39.49±15.07) pg/mL] in group A, group B, group C and group D (P<0.05). The comparison in MACE incidence showed that there was no statistical difference between normal BNP group and mild-higher BNP group (P>0.05), and there was statistical difference among all other BNP groups (P<0.05). The incidence of MACE showed an increasing trend in normal BNP group, mild-higher BNP group and marked-higher BNP group. Conclusion The level of BNP can be taken as a clinical index for reviewing the short-term prognosis in the patients with STEMI.