CAJ | 학술논문

目的：评价B-型钠尿肽（BNP）及D-二聚体（D-dimer）在老年急性心肌梗死（AMI）预后判断中的临床应用价值。方法选择发病6 h内的老年急性心肌梗死患者123例为观察组，无冠状动脉疾病的体检者46例为对照组。采用化学发光法及免疫比浊法检测入选者血浆BNP及D-dimer水平，并对观察组患者随访1年，平均3个月随访1次。结果 AMI后血浆BNP及D-dimer水平与对照组比较明显升高（P﹤0.01）。AMI组、心力衰竭组和死亡组血浆中BNP、D-dimer水平显著高于梗死后心绞痛组和治疗后恢复期组（ P﹤0.01）。住院期间及1年随访期间发生心血管事件患者的血浆BNP水平明显高于未发生者（ P﹤0.01），心血管事件在BNP较高的患者中也较多（ P﹤0.05），血浆BNP水平与病死率呈正相关（r=0.54，P﹤0.01）。AMI早期治疗后血浆BNP与D-dimer水平显著下降（P﹤0.01）。结论血浆BNP及D-dimer水平在老年AMI患者中明显升高，且升高水平与病情的严重程度密切相关，故血浆BNP、D-dimer水平对老年AMI患者病情的转归和疗效评估有实际的临床价值。
목적：평개B-형납뇨태（BNP）급D-이취체（D-dimer）재노년급성심기경사（AMI）예후판단중적림상응용개치。방법선택발병6 h내적노년급성심기경사환자123례위관찰조，무관상동맥질병적체검자46례위대조조。채용화학발광법급면역비탁법검측입선자혈장BNP급D-dimer수평，병대관찰조환자수방1년，평균3개월수방1차。결과 AMI후혈장BNP급D-dimer수평여대조조비교명현승고（P﹤0.01）。AMI조、심력쇠갈조화사망조혈장중BNP、D-dimer수평현저고우경사후심교통조화치료후회복기조（ P﹤0.01）。주원기간급1년수방기간발생심혈관사건환자적혈장BNP수평명현고우미발생자（ P﹤0.01），심혈관사건재BNP교고적환자중야교다（ P﹤0.05），혈장BNP수평여병사솔정정상관（r=0.54，P﹤0.01）。AMI조기치료후혈장BNP여D-dimer수평현저하강（P﹤0.01）。결론혈장BNP급D-dimer수평재노년AMI환자중명현승고，차승고수평여병정적엄중정도밀절상관，고혈장BNP、D-dimer수평대노년AMI환자병정적전귀화료효평고유실제적림상개치。
Objective To evaluate the clinical application value of B-type natriuretic peptide and D-dimer on the prognosis judgement of elderly patients with acute myocardial infarction( AMI ). Methods One hundred and twenty-three AMI patients within six hours of onset were chose as observa-tion group,and 46 physical examinees without coronary artery disease were chose as control group. The plasma BNP and D-dimer levels were detected by chemiluminescence and immunoturbidimetry,and the patients in observation group were followed up for 1 year,every 3 months one time. Results After AMI, the plasma BNP and D-dimer levels were significantly higher than those of the control group( P﹤0. 01 ). The BNP and D-dimer levels in plasma of AMI group,heart failure group and death group were signifi-cantly higher than those of the post-infarction angina group and recovery group( P﹤0. 01 ). The plasma BNP levels in patients with cardiovascular events during hospitalization and 1-year follow-up were signifi-cantly higher than those in patients without cardiovascular events( P ﹤0. 01 ). Cardiovascular events in patients with higher BNP levels were more( P﹤0 . 05 ). The plasma BNP levels were positively correlated with mortality( r=0. 54 ,P﹤0. 01 ). The plasma BNP and D-dimer levels of patients with AMI signifi-cantly decreased after early treatment( P﹤0. 01 ). Conclusions The plasma BNP and D-dimer levels of elderly patients with AMI increase obviously,and the elevated levels are closely correlated with the sever-ity of the disease,so the plasma BNP and D-dimer levels have practical clinical value on the disease out-come and efficacy assessments of the elderly patients with AMI.