CAJ | 학술논문

目的：探讨血浆N末端脑钠肽前体（NT-proBNP）浓度的下降率与急性心肌梗死患者的预后的关系。方法入选2012年10月至2013年10月在内蒙古医科大学第四附属医院心内科住院的急性心肌梗死患者100例，其中男性61例，女性39例，年龄45~76岁。于发病第7 d及21 d，分别测定血浆NT-proBNP，并计算每位患者NT-proBNP的下降率，分为A组（下降率＞30%）和B组（下降率＜30%）。记录两组患者入院到6个月内心血管不良事件发生率，于入院1周及发病6个月时测定每位患者的左室射血分数（LVEF）。结果两组在性别、年龄、吸烟史、高血压、高血脂等方面比较差异均无统计学意义（P均＞0.05）。发病1周时，A组与B组LVEF比较，差异无统计学意义（P＞0.05）。发病6月后，A组患者LVEF较B组升高[（54.75±5.18）%vs.（34.65±8.11）%]，差异具有统计学意义（P＜0.05）。两组随访6月后，心血管不良事件发生率A组明显低于B组（11%vs.30%），差异具有统计学意义（P＜0.05）。结论 NT-proBNP浓度与急性心肌梗死患者的预后有关，NT-proBNP下降率＞30%的患者预后较NT-proBNP下降率＜30%好，总的心血管不良事件发生率低。
목적：탐토혈장N말단뇌납태전체（NT-proBNP）농도적하강솔여급성심기경사환자적예후적관계。방법입선2012년10월지2013년10월재내몽고의과대학제사부속의원심내과주원적급성심기경사환자100례，기중남성61례，녀성39례，년령45~76세。우발병제7 d급21 d，분별측정혈장NT-proBNP，병계산매위환자NT-proBNP적하강솔，분위A조（하강솔＞30%）화B조（하강솔＜30%）。기록량조환자입원도6개월내심혈관불량사건발생솔，우입원1주급발병6개월시측정매위환자적좌실사혈분수（LVEF）。결과량조재성별、년령、흡연사、고혈압、고혈지등방면비교차이균무통계학의의（P균＞0.05）。발병1주시，A조여B조LVEF비교，차이무통계학의의（P＞0.05）。발병6월후，A조환자LVEF교B조승고[（54.75±5.18）%vs.（34.65±8.11）%]，차이구유통계학의의（P＜0.05）。량조수방6월후，심혈관불량사건발생솔A조명현저우B조（11%vs.30%），차이구유통계학의의（P＜0.05）。결론 NT-proBNP농도여급성심기경사환자적예후유관，NT-proBNP하강솔＞30%적환자예후교NT-proBNP하강솔＜30%호，총적심혈관불량사건발생솔저。
Objective To discuss the relationship between reduction rate of N-terminal pro brain natriuretic peptide (NT-proBNP) and prognosis in patients with acute myocardial infarction (AMI). Methods AMI patients (n=100, male 61, female 39 and aged from 45 to 76) were chosen from Oct. 2012 to Oct. 2013. The level of plasma NT-proBNP was detected and reduction rate of NT-proBNP was calculated on the 7th d and 21st d after AMI attack, and then all patients were divided into group A (reduction rate>30%) and group B (reduction rate<30%). The incidence of major adverse cardiovascular events (MACE) was recorded from hospitalization time to 6 m later. The changes of left ventricular ejection fraction (LVEF) were detected respectively 1 w and 6 m after hospitalization. Results The difference in sex, age, smoking history, hypertension and hyperlipidemia had no statistical significance between 2 groups (all P>0.05). After 1 w, the difference in LVEF had no statistical significance between 2 groups (P>0.05). After 6 m, LVEF increased in group A compared with group B [(54.75±5.18)%vs. (34.65±8.11)%, P<0.05]. After following up for 6 m, the incidence of MACE was significantly lower in group A than that in group B (11%vs. 30%, P<0.05). Conclusion The level of NT-proBNP is correlated to prognosis in AMI patients. The prognosis is better and incidence of MACE is lower in patients with NT-proBNP reduction rate>30%than those in patients with NT-proBNP reduction rate<30%.