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目的分析非ST段抬高急性冠状动脉综合征(non-ST elevation acute coronary syndrome,NSTE-ACS)患者B型钠尿肽水平(B-type natriuretic peptide,BNP)的变化与LVEF的相关性,评估BNP在NSTE-ACS患者近期心功能中的预测作用。方法入选NSTE-ACS患者138例,依据入院后治疗方式分为:6 h内PCI组(组1,47例),5～7 d PCI组(组2,50例),药物保守治疗组(组3,41例)。所有患者于入院即刻、发病48 h及7 d时,测定静脉血清BNP,1个月后测LVEF,比较不同时间点BNP的差异,分析BNP水平与1个月后LVEF的关系。结果 3组患者入院即刻和发病48 h时BNP水平差异无统计学意义(P=0.086、0.279);发病7 d时,与组2和组3比较,组1BNP水平显著下降(P=0.006、0.001);组2与组3比较,差异无统计学意义(P=0.052)。发病7 d BNP水平与1个月后LVEF呈显著负相关(r=-0.56,P<0.01)。结论在NSTE-ACS患者中,早期介入治疗可以显著降低发病7 d时BNP水平,BNP水平与近期心功能状态呈显著负相关。
Objective To analyze the association between changes of B-type natriuretic peptide (BNP) and LVEF in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) Predictive effect of BNP in recent cardiac function in NSTE-ACS patients. Methods One hundred and thirty-eight patients with NSTE-ACS were enrolled in this study. According to the post-admission treatment, PCI group (1,47 cases) within 6 hours, PCI group (2,50 cases) 3,41 cases). The venous serum BNP was measured at 48 h and 7 d after onset, and LVEF was measured after 1 month. The differences of BNP at different time points were analyzed. The relationship between BNP level and LVEF after 1 month was analyzed. Results There was no significant difference in BNP levels between the three groups immediately after admission and at 48 hours (P = 0.086,0.279). On the 7th day after onset, the level of 1BNP was significantly decreased compared with groups 2 and 3 (P = 0.006,0.001 ); Group 2 and Group 3, the difference was not statistically significant (P = 0.052). The level of BNP on the 7th day was significantly negatively correlated with LVEF after 1 month (r = -0.56, P <0.01). Conclusion In NSTE-ACS patients, early intervention can significantly reduce the level of BNP on the seventh day after onset, and the BNP level has a significant negative correlation with the recent cardiac function.