CAJ | 학술논문

目的：了解氨基末端B型钠尿肽原（NT-proBNP）水平对于胸闷胸痛患者发生心血管死亡事件的预示意义。方法检测急诊入院的288例胸闷胸痛患者的实验室相关生化免疫项目[包括心肌肌钙蛋白 T、NT-proBNP、C 反应蛋白、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白 A、脂蛋白（a）、肌酸激酶、肌酸激酶同工酶 MM亚型]，采用两组间 t 检验、秩和检验以及卡方检验分析出有差异的检测项目，再结合3年后对手术患者电话随访调查结果进行 Logistic 回归以及受试者工作特征（ROC）曲线分析。结果随访发现术后3年期间内发生心血管死亡事件的患者其术前血清 NT-proBNP 水平显著高于未发生者（P ＜0．001）。Logistic 回归分析显示 NT-proBNP 水平可以作为预示心血管死亡事件发生的危险因素，其优势比（OR）为1．97[95％可信区间（CI）：1．14～3．39，P ＝0．015]。在心血管高危人群的 NT-proBNP 四分位组中，NT-proBNP 水平对人群中心血管事件再入院的发生也具有预示作用。NT-proBNP 水平与年龄具有一定的相关性。ROC 曲线显示 NT-proBNP 的曲线下面积（AUC）为0．714（95％可信区间为0．504～0．925），可作为预示心血管死亡的指标。结论心血管疾病高危患人群的术前 NT-proBNP 水平能够预示这一人群中发生心血管死亡事件的风险。
목적：료해안기말단B형납뇨태원（NT-proBNP）수평대우흉민흉통환자발생심혈관사망사건적예시의의。방법검측급진입원적288례흉민흉통환자적실험실상관생화면역항목[포괄심기기개단백 T、NT-proBNP、C 반응단백、감유삼지、저밀도지단백담고순、고밀도지단백담고순、재지단백 A、지단백（a）、기산격매、기산격매동공매 MM아형]，채용량조간 t 검험、질화검험이급잡방검험분석출유차이적검측항목，재결합3년후대수술환자전화수방조사결과진행 Logistic 회귀이급수시자공작특정（ROC）곡선분석。결과수방발현술후3년기간내발생심혈관사망사건적환자기술전혈청 NT-proBNP 수평현저고우미발생자（P ＜0．001）。Logistic 회귀분석현시 NT-proBNP 수평가이작위예시심혈관사망사건발생적위험인소，기우세비（OR）위1．97[95％가신구간（CI）：1．14～3．39，P ＝0．015]。재심혈관고위인군적 NT-proBNP 사분위조중，NT-proBNP 수평대인군중심혈관사건재입원적발생야구유예시작용。NT-proBNP 수평여년령구유일정적상관성。ROC 곡선현시 NT-proBNP 적곡선하면적（AUC）위0．714（95％가신구간위0．504～0．925），가작위예시심혈관사망적지표。결론심혈관질병고위환인군적술전 NT-proBNP 수평능구예시저일인군중발생심혈관사망사건적풍험。
Objective To investigate the role of N-terminal B-type natriuretic peptide (NT-proBNP)level for predicting cardiovascular death events in patients with chest distress and chest pain.Methods A total of 288 patients who were going to emergency with chest distress and chest pain were enrolled.The cardiac troponin T,NT-proBNP,C-reactive protein,triglyceride,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,apolipoprotein A, lipoprotein(a),creatine kinase and creatine kinase-MMwere determined.The statistical methods contained t test,rank sum test and Chi-square test.Logistic regression analysis and receiver operating characteristic (ROC)curve analysis were performed.Results The serum NT-proBNP in the cardiovascular death event follow-up group for 3 years was higher than that without events (P <0.001 ).Logistic regression analysis showed that NT-proBNP can be as the prediction risk factor for cardiovascular death events,and the odds ratio was 1 .97 [95% confidence interval (CI):1 .1 4-3.39,P =0.01 5].Among the 4 groups which were classified by the quarter level of NT-proBNP,the level of NT-proBNP can also predict the readmission to hospitals in the follow-ups.The level of NT-proBNP was related with ages. The ROC curve showed that the area under the curve (AUC)of NT-proBNP was 0.71 4 (95%CI:0.504-0.925 ), which can be as a predictive parameter for cardiovascular death events.Conclusions The level of NT-proBNP before the treatment can be used to predict the occurrence of cardiovascular death events in high-risk cardiovascular patients.