脑钠肽对不稳定型心绞痛和(或)非ST段抬高心肌梗死患者冠状动脉病变程度的预测被引量：26

The value of brain natriuretic peptide to evaluate narrowed coronary artery inunstable angina/Non-ST elevation myocardial infarction

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摘要目的:评价脑钠肽和不稳定型心绞痛和(或)非ST段抬高心肌梗死(UA/NSTEMI)患者冠状动脉(冠脉)病变程度的关系及脑钠肽对左主干狭窄的预测价值。方法:对资料完整的141例UA/NSTEMI按脑钠肽(BNP)水平分为4个百分位数组,BNP≤P25(78.0ng/L)组、P26～P50(78.1～26.5ng/L)组、P51～P75(265.1～368.0ng/L)组和>P75(368.0ng/L)组。对各组间不同冠脉病变支数的百分率进行χ2检验,以受试者工作曲线(ROC)来分析BNP预测左主干狭窄的临床意义。结果:>P75组冠脉3支病变比率显著高于≤P25组、P26～P50组和P51～P75组,而单支冠脉病变比率显著低于上述3组;Gensini积分随着4组的BNP水平升高亦增高,且>P75组显著高于≤P25组和P26～P50组。ROC分析示BNP用于判断左主干狭窄有显著意义(P<0.01),BNP水平越高则左主干狭窄的可能性越大;BNP水平为310ng/L时,其预测左主干狭窄的灵敏度为84.2%,特异度为70.5%。结论:在UA/NSTEMI患者中BNP水平越高,其冠脉病变程度越重,BNP可作为预测UA/NSETEMI患者左主干狭窄的一个有效指标。 Objective：To evaluate the relation of brain natriuretic peptide（BNP） levels and the degree of coronary artery stenosis in unstable angina/non-st elevation myocardial infarction （UA/NSTEMI） patients, and evaluate the value of the estimation of BNP to left main coronary stenosis. Method： One hundred and forty-one UA/ NSTEMI patients whose clinical data include serum BNP level were complete were enrolled, and were divided into four quartile groups based on the BNP level. Then compared the ratio of single coronary artery stenosis or double coronary artery stenosis or three coronary artery stenosis in the four groups with Chi-Square test. ROC curve of BNP level was used to analysis the predictive value for left main coronary artery stenosis. Result： There were 141 patients whose clinical data include serum BNP level were complete, and divided into four groups based on the BNP level . The ratio of three vessels coronary artery stenosis in the P75 group was the highest among the four groups, and the ratio of single vessels coronary artery stenosis in the P75 group was the lowest. ROC curve of BNP level analysis showed BNP was valuable for the prediction of left main coronary artery stenosis （P = 0. 000）, increasing quartiles of BNP levels were associated with increasing left main coronary artery stenosis ratio. The predictive sensitivity of main coronary artery stenosis was 84.2 % and the specificity was 70.5 % when BNP level was 310 ng/L. Conclusion： Increased plasma BNP levels were associated with deteriorated coronary artery stenosis in UA/NSTEMI patients. The BNP level can be a predictive factor for left main coronary artery stenosis.

作者苏华周胜华潘宏伟杜优优刘彬刘厂辉

机构地区中南大学附属湘雅二医院心内科南华大学第一附属医院心内科

出处《临床心血管病杂志》 CAS CSCD 北大核心 2008年第2期117-119,共3页 Journal of Clinical Cardiology

关键词脑钠肽心绞痛不稳定型心肌梗死 Brain natriuretic peptide Angina, unstable Myocardial infarction

分类号 R541.4 [医药卫生—心血管疾病]

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参考文献5

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二级参考文献4

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