CAJ | 학술논문

目的：探讨急性冠状动脉综合征（ACS）患者血浆氨基末端脑钠肽前体（NT-proBNP）水平及全球急性冠状动脉事件注册（ GRACE）危险评分与冠状动脉病变相关性。方法选取2012年2月—2014年9月在心内科住院诊断为ACS患者315例，统计患者基本临床资料及入院24 h内实验室检查结果，所有患者均进行GRACE危险评分并行冠状动脉造影，分析ACS患者冠状动脉病变的特点、血浆NT-proBNP水平及GRACE危险评分与冠状动脉病变的关系。结果根据GRACE危险评分分为低危组85例，中危组124例，高危组106例，其中GRACE危险评分高危组患者冠状动脉病变双支、三支明显多于中、低危组（ P ＜0?.05），冠状动脉狭窄程度明显重于中、低危组（ P ＜0.05），Geninis积分明显高于中、低危组（ P ＜0.05）。根据冠状动脉造影结果分为单支病变组123例、双支病变组94例，三支病变组98例，其中双支病变组、三支病变组GRACE危险评分高于单支病变组（ P ＜0.05），三支病变组患者血浆NT-proB-NP水平明显高于单支、双支病变组（ P ＜0.05）。 GRACE危险评分高危组患者血浆NT-proBNP水平明显高于中、低危组（ P ＜0.05），且GRACE危险评分与血浆NT-proBNP水平呈正相关（ r =0.42， P ＜0.05）。结论血浆NT-proB-NP水平及GRACE危险评分与冠状动脉病变具有良好相关性，对ACS患者冠状动脉病变支数、狭窄程度有一定的预测价值。
목적：탐토급성관상동맥종합정（ACS）환자혈장안기말단뇌납태전체（NT-proBNP）수평급전구급성관상동맥사건주책（ GRACE）위험평분여관상동맥병변상관성。방법선취2012년2월—2014년9월재심내과주원진단위ACS환자315례，통계환자기본림상자료급입원24 h내실험실검사결과，소유환자균진행GRACE위험평분병행관상동맥조영，분석ACS환자관상동맥병변적특점、혈장NT-proBNP수평급GRACE위험평분여관상동맥병변적관계。결과근거GRACE위험평분분위저위조85례，중위조124례，고위조106례，기중GRACE위험평분고위조환자관상동맥병변쌍지、삼지명현다우중、저위조（ P ＜0?.05），관상동맥협착정도명현중우중、저위조（ P ＜0.05），Geninis적분명현고우중、저위조（ P ＜0.05）。근거관상동맥조영결과분위단지병변조123례、쌍지병변조94례，삼지병변조98례，기중쌍지병변조、삼지병변조GRACE위험평분고우단지병변조（ P ＜0.05），삼지병변조환자혈장NT-proB-NP수평명현고우단지、쌍지병변조（ P ＜0.05）。 GRACE위험평분고위조환자혈장NT-proBNP수평명현고우중、저위조（ P ＜0.05），차GRACE위험평분여혈장NT-proBNP수평정정상관（ r =0.42， P ＜0.05）。결론혈장NT-proB-NP수평급GRACE위험평분여관상동맥병변구유량호상관성，대ACS환자관상동맥병변지수、협착정도유일정적예측개치。
Objective To investigate the correlation between acute coronary syndrome ( ACS) patients with plasma N-terminal pro brain natriuretic peptide (NT-proBNP), the level of global registration of acute coronary events (GRACE) risk score and the severity of coronary artery lesions .Methods From 2012 February to 2014 September , 315 cases of ACS pa-tients in Department of Cardiology were enrolled , the patients'clinical data and 24 h laboratory results were analyzed , all pa-tients underwent GRACE risk score and coronary angiography , ACS patient coronary artery lesions characteristics , the plasma NT-proBNP level , GRACE risk score and the severity of coronary artery lesions 'relationship were analyzed .Results Accor-ding to the results of GRACE risk score , patients were divided into the low risk group with 85 cases, medium risk group with 124 cases, high risk groups with 106 cases, two vessel,three vessel coronary lesions in high risk group were significantly more than medium and low risk group ( P <0.05), coronary artery stenosis degree was significantly severe than the medium and low risk group ( P <0.05), Geninis score was significantly higher than the medium and low risk group ( P <0.05).Ac-cording to the results of coronary angiography , they were divided into single vessel group with 123 cases, two vessel group with 94 cases, three vessel group with 98 cases, in which the two vessel group , three vessel group 's GRACE risk score were higher than that of single vessel lesion group ( P <0.05), three vessel group's NT-proBNP levels were significantly higher than that of single, two vessel group ( P <0.05).The GRACE risk score, plasma NT-proBNP levels in patients with high-risk group were significantly higher than that of medium and low risk group ( P <0.05), and the GRACE risk score were positively cor-related with plasma NT-proBNP levels ( r =0.42, P <0.05).Conclusion Plasma NT-proBNP levels, GRACE risk score were correlated with the severity of coronary artery stenosis , it has great values in predicting the severity of coronary artery le-sions in patients with ACS .