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目的评估血浆B型利钠肽(BNP)水平对非ST段抬高性急性冠脉综合征(NSTE-ACS)患者预后的预测价值。方法入选NSTE-ACS患者180例,所有患者于发病第24小时采用免疫荧光法测定血浆BNP水平,根据24 hBNP水平将患者分为血浆BNP≥80 ng/L组与BNP<80 ng/L组。对所有患者随访6个月,观察早期BNP水平与随访6个月主要不良心血管事件发生的关系。结果随访6个月,180例患者中有42例(23%)患者发生主要不良心血管事件,血浆BNP≥80 ng/L组患者主要不良心血管事件发生率明显高于BNP<80 ng/L组患者(P=0.003),在校正了年龄、性别、高血压病、糖尿病、高脂血症、吸烟及左室射血分数等影响预后的危险因素后,NSTE-ACS患者入院早期血浆BNP水平≥80 ng/L与随访6个月发生主要不良心血管事件显著相关[校正RR=3.625,95%CI(1.505～8.731),P=0.004]。结论 NSTE-ACS患者早期BNP水平增高有助于评价NSTE-ACS患者6个月主要不良心血管事件的发生,可应用于危险分层的评估。
Objective To evaluate the predictive value of plasma BNP level in the prognosis of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods 180 patients with NSTE-ACS were enrolled in this study. Plasma BNP levels were measured by immunofluorescence in all patients at 24 hours after the onset of disease. Patients were divided into two groups according to the levels of BNP≥80 ng / L and BNP <80 ng / L. All patients were followed up for 6 months and the relationship between early BNP level and the incidence of major adverse cardiovascular events at 6 months follow-up was observed. Results Six months after follow-up, 42 (23%) of 180 patients developed major adverse cardiovascular events. The incidence of major adverse cardiovascular events was significantly higher in patients with plasma BNP> 80 ng / L than those with BNP <80 ng / L (P = 0.003). After adjusting for risk factors such as age, gender, hypertension, diabetes mellitus, hyperlipidemia, smoking and left ventricular ejection fraction that influenced prognosis, plasma BNP levels in patients with NSTE-ACS Significant associations of ≥80 ng / L with major adverse cardiovascular events at 6 months of follow-up [adjusted RR = 3.625, 95% CI 1.505 to 8.731, P = 0.004]. Conclusion The increase of early BNP level in patients with NSTE-ACS is helpful to evaluate the incidence of major adverse cardiovascular events at 6 months in patients with NSTE-ACS and can be used in the assessment of risk stratification.