摘要
目的 探讨基线N末端B型钠尿肽原(NT-pro BNP)与不稳定性心绞痛(UA)患者左心射血分数(LVEF)和院内主要心血管不良事件(MACCE)关系。方法 回顾性分析我院2010年1月至2020年1月收治UA患者共1486例临床资料,根据入院当天NT-pro BNP水平分组,比较不同组一般资料、住院检查指标、心功能指标、冠脉病变指标、治疗相关指标及MACCE发生情况,采用Logistic回归模型分析UA患者LVEF和院内MACCE独立影响因素。结果 (1)四组年龄、性别、合并高血压、吸烟史、既往心肌梗死病史、既往PCI史及既往CAGB史比例比较差异有统计学意义(P<0.05);D组年龄、合并高血压、既往心肌梗死病史、既往PCI史及既往CAGB史比例均显著高于A组、B组及C组(P<0.05);D组男性和吸烟史比例均显著低于A组、B组及C组(P<0.05);(2)四组血压、BMI、TG、TC、LDL-C、LVEF及NYHA分级Ⅲ~Ⅳ级比例比较差异有统计学意义(P<0.05);D组SBP、Scr及NYHA分级Ⅲ~Ⅳ级比例显著高于A组、B组及C组(P<0.05);D组DBP、BMI、TG及LVEF水平均显著低于A组、B组及C组(P<0.05);A组TC和LDL-C水平均显著高于B组、C组及D组(P<0.05);(3)四组三支及以上病变、CAGB、服用阿司匹林/氯吡格雷/他汀/钙通道阻滞剂/β受体阻滞剂比例比较差异有统计学意义(P<0.05);D组三支及以上病变比例和服用β受体阻滞剂比例显著高于A组、B组及C组(P<0.05);D组CAGB比例、服用阿司匹林/他汀比例显著低于A组、B组(P<0.05);(4)四组院内MACCE发生率比较差异有统计学意义(P<0.05);D组院内MACCE发生率显著高于A组、B组及C组(P<0.05);(5)Logistic回归模型多因素分析结果显示,心肌梗死病史、HR及基线NT-pro BNP水平均是UA患者LVEF<50%独立影响因素(P<0.05);同时既往PCI史、既往CAGB史及NYHA分级是UA患者MACCE发生独立影响因素(P<0.05)。结论 UA患者基线NT-pro BNP水平与LVEF独立相关,但无法准确预测院内MACCE发生风险。
Objective To investigate the relationship between baseline NT-proBNP and LVEF and MACCE in hospital of patients with UA.Methods Clinical data of 1486 patients with UA were chosen in the period from January 2010 to January 2020.All patients were divided into different groups according to the level of NT-proBNP on the admission day;the general data,in-hospital examination index,cardiac function index,coronary artery disease index,treatment-related index and the incidence of MACCE in different groups were compared.The independent influencing factors of LVEF and MACCE in hospital of UA patients were analyzed by logistic regression model.Results(1)There were significant differences in age,proportion gender,hypertension,smoking history,myocardial infarction history,PCI history and CAGB history among 4 groups(P<0.05).The age,proportion hypertension,myocardial infarction,PCI and CAGB in group D were significantly higher than group A,B and C(P<0.05).The proportion of men and smoking history in group D was significantly lower than group A,B and C(P<0.05).(2)There were significant differences in blood pressure,BMI,TG,TC,LDL-C,LVEF and proportion of NYHA classification for III-IV stage among 4 groups(P<0.05).The SBP,Scr and proportion of NYHA classification for III-IV stage in group D was significantly higher than group A,B and C(P<0.05).The DBP,BMI,TG and LVEF in group D were significantly lower than group A,B and C(P<0.05).The TC and LDL-C in group A were significantly higher than group B,C and D(P<0.05).(3)There were significant differences in the proportion of three or more lesions,CAGB,aspirin/clopidogrel/statins/calcium channel blockers/βreceptor blockers among 4 groups(P<0.05).The proportion of three or more lesions andβreceptor blockers in group D were significantly higher than group A,B and C(P<0.05).The proportion of CAGB and aspirin/statins in group D were significantly lower than group A and B(P<0.05).(4)There were significant difference in the incidence of MACCE among 4 groups(P<0.05).The incidence of MACCE in group D was significantly higher than group A,B and C(P<0.05).(5)Logistic regression analysis showed that the history of myocardial infarction,HR and baseline NT-proBNP water were the independent influencing factors of LVEF<50%in patients with UA(P<0.05).The history of PCI,CAGB and NYHA were the independent influencing factors of MACCE in patients with UA(P<0.05).Conclusion The baseline NT-proBNP level of UA patients was independently correlated with LVEF,but it was unable to accurately predict the risk of MACCE in hospital.
作者
丰俊鹏
王艳敏
FENG Jun-peng;WANG Yan-min(Department of Cardiology,Pingdingshan Traditional Chinese Medicine Hospital,Pingdingshan 467000,Henan Province,China)
出处
《罕少疾病杂志》
2025年第3期77-80,共4页
Journal of Rare and Uncommon Diseases
基金
河南中医药传承与创新人才工程(仲景工程)中医药拔尖人才(豫卫中医函[2021]15号)。
关键词
N末端B型钠尿肽原
不稳定性心绞痛
左心射血分数
主要心血管不良事件
关系
N-terminal B-type Natriuretic Peptide
Unstable Angina Pectoris
Left Ventricular Ejection Fraction
Major Cardiovascular Adverse Events
Relationship
