CAJ | 학술논문

目的：分析冠心病患者血清N末端B型利钠肽原(NT-proBNP)水平与冠状动脉病变程度及主要不良心血管事件(MACE)的相关性。方法回顾性分析2012年员月~2014年12月在重庆市綦江区人民医院(以下简称“我院”)住院的120例患者的临床资料,根据患者的临床症状将其分为稳定型心绞痛(SAP)组37例、不稳定型心绞痛(UAP)组38例、急性心肌梗死(AMI)组45例；根据患者冠状动脉病变支数分为1支组68例、2支组31例、3支组21例；同时根据是否发生MACE将患者分为非MACE组76例和MACE组44例。选择我院同期健康体检且经冠状动脉造影证实为非冠心病者35名作为对照组。观察比较各组NT-proBNP水平、Gensini评分,统计分析NT-proBNP水平与Gensini评分及MACE的相关性。结果SAP组、UAP组、AMI组患者NT-proBNP水平明显高于对照组,差异均有高度统计学意义(P<0.01)；UAP组和AMI组NT-proBNP水平及Gensini评分明显高于SAP组,差异有统计学意义(P<0.05或P<0.01)；AMI组NT-proBNP水平及Gensini评分明显高于UAP组,差异有高度统计学意义(P<0.01)。随着冠状动脉病变支数的增加,患者血清NT-proBNP水平及Gensini评分逐渐升高,差异均有统计学意义(P<0.05或P<0.01)。MACE组患者血清NT-proBNP水平明显高于非MACE组,差异有高度统计学意义(P<0.01)。相关性分析结果显示,患者血清NT-proBNP水平与Gensini评分呈正相关(r =0.537,P<0.05)。结论冠心病患者血清NT-proBNP水平与冠状动脉病变程度具有明显的相关性,且检测NT-proBNP水平对MACE的预测具有一定的价值。
목적：분석관심병환자혈청N말단B형리납태원(NT-proBNP)수평여관상동맥병변정도급주요불양심혈관사건(MACE)적상관성。방법회고성분석2012년원월~2014년12월재중경시기강구인민의원(이하간칭“아원”)주원적120례환자적림상자료,근거환자적림상증상장기분위은정형심교통(SAP)조37례、불은정형심교통(UAP)조38례、급성심기경사(AMI)조45례；근거환자관상동맥병변지수분위1지조68례、2지조31례、3지조21례；동시근거시부발생MACE장환자분위비MACE조76례화MACE조44례。선택아원동기건강체검차경관상동맥조영증실위비관심병자35명작위대조조。관찰비교각조NT-proBNP수평、Gensini평분,통계분석NT-proBNP수평여Gensini평분급MACE적상관성。결과SAP조、UAP조、AMI조환자NT-proBNP수평명현고우대조조,차이균유고도통계학의의(P<0.01)；UAP조화AMI조NT-proBNP수평급Gensini평분명현고우SAP조,차이유통계학의의(P<0.05혹P<0.01)；AMI조NT-proBNP수평급Gensini평분명현고우UAP조,차이유고도통계학의의(P<0.01)。수착관상동맥병변지수적증가,환자혈청NT-proBNP수평급Gensini평분축점승고,차이균유통계학의의(P<0.05혹P<0.01)。MACE조환자혈청NT-proBNP수평명현고우비MACE조,차이유고도통계학의의(P<0.01)。상관성분석결과현시,환자혈청NT-proBNP수평여Gensini평분정정상관(r =0.537,P<0.05)。결론관심병환자혈청NT-proBNP수평여관상동맥병변정도구유명현적상관성,차검측NT-proBNP수평대MACE적예측구유일정적개치。
Objective To analyze correlation of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels with the severity of coronary artery lesions and the incidence of major adverse cardiovascular events (MACE). Methods The clinical data of 120 patients from January 2012 to December 2014 in Chongqing Qijiang People's Hospital (“our hospital”for short) was retrospectively analyzed, they were divided into the stable angina pectoris (SAP) group (37 cases), unstable angina pectoris (UAP) group (38 cases), acute myocardial infarction (AMI) group (45 cases) according to the clinical symptoms of patients;the patients were divided into 1 coronary artery lesion group (68 cases), 2 coronary artery lesions group (31 cases), and 3 coronary artery lesions group (21 cases) according to the number of coronary artery lesions;at the same time, according to whether there were MACE, they were divided into MACE group (76 cases) and without MACE group (44 cases). 35 cases confirmed without coronary heart disease at the same time in our hospital were selected as control group. The levels of NT-proBNP and Gensini scores of those groups were observed and analyzed, the correlation of NT-proBNP with Gensini scores and MACE were statistically analyzed. Results The levels of NT-proBNP in SAP group, UAP group, AMI group were significantly higher than those of the control group, the differences were statistically significant (P<0.01);the serum levels of NT-proBNP and Gensini score in the UAP group and AMI group were signif-icantly higher than those of SAP group, the differences were statistically significant (P<0.05 or P<0.01), and the lev-differences were statistically significant (P< 0.01). With the increase of coronary artery lesion counts, patient's serum level of NT-proBNP and Gensini score increased, the differences were statistically significant (P< 0.05 or P<0.01). The serum levels of NT-proBNP of the MACE group was significantly higher than that of without MACE group, the dif-ference was statistically significant (P< 0.01). Correlation analysis results showed that, patients' serum level of NT-proBNP was positively correlated with Gensini score (r=0.537, P< 0.05). Conclusion The serum level of NT-proBNP in patients with coronary heart disease has obvious correlation with the extent of coronary artery lesions, and detection of the NT-proBNP level has a certain value for the forecast of MACE.