摘要
目的:探讨N末端脑钠肽前体(NT-proBNP)、胱抑素C(CysC)和降钙素原(PCT)在急性冠脉综合征(ACS)患者预后中的价值。方法:将120例ACS患者根据病症不同分为不稳定心绞痛(UAP)和急性心机梗死(AMI)两组,每组60例,另选取同期60例健康体检者为对照组。对比3组受试者外周血NT-proBNP、CysC、PCT水平及Gensini评分;随访12个月,研究不同预后ACS患者各指标的差异,并分析各指标预测ACS患者近期发生不良心血管事件(MACE)的价值。结果:UAP组和AMI组患者外周血NT-proBNP、CysC、PCT水平及Gensini评分均显著高于对照组,且AMI组显著高于UAP组(P<0.05)。随着冠脉病变支数的增加,ACS患者NT-proBNP、CysC、PCT水平及Gensini评分也显著增加(P<0.05)。Pearson相关性分析结果显示,ACS患者外周血NT-proBNP、CysC、PCT水平与Gensini评分呈正相关关系(P<0.05)。发生MACE的患者外周血NT-proBNP、CysC、PCT水平显著高于无MACE患者(P<0.05)。ROC曲线显示,NT-proBNP、CysC、PCT的曲线下面积分别为0.825、0.734、0.670,其预测灵敏度分别为68.8%、81.3%、75.0%,特异度分别为84.1%、68.2%、56.8%。结论:外周血NT-proBNP、CysC、PCT水平与ACS患者冠状动脉病变程度和预后密切相关,可作为评估患者预后的重要预测指标。
Objective： To investigate the value of N-terminal pro-brain natriuretic peptide （NT-proBNP）, cystatin C （CysC） and proealcitonin （PCT） levels in the prognostic assessment of patients with acute coro- nary syndrome （ACS）. Methods ：120 patients with ACS were divided into unstable angina pectoris （UAP） group and acute myocardial infarction （AMI） group, with 60 cases each, and 60 healthy vonlenteers were enrolled as a control group. The levels of NT-proBNP, CysC and PCT in plasma and Gensini sore were compared among groups. After 12 months follow-up, the changes of above indexes were observed, and the prognostic value was analyzed. Results：The levels of NT-proBNP, CysC and PCT in plasma and Gensini score in UAP group and AMI group were significantly higher than those in the control group, whereas these indexes in AMI group were notably higher than UAP group （P〈0.05）. The levels of NT-proBNP, CysC and PCT in plasma and Gensini score were significantly increased with the numbers of diseased coro- nary arteries increased （P〈0.05）. Pearson correlation analysis showed that the levels of NT-proBNP, Cy- sC and PCT were positively correlated with Gensini score （P〈0.05）. Patients with major adverse cardiac events （MACE） had higher levels of NT-proBNP, CysC and PCT than those without （P〈0.05）. The area under the ROC curve were 0. 825, 0. 734 and 0. 670, the sensibility were 68.8%, 81.3% and 75.0%, and the specificity were 84.1%, 68.2% and 56.8%, respectively in NT-proBNP, CysC and PCT. Conclusion： The levels of NT-proBNP, CysC and PCT in plasma were correlated with the lesion degree of coronary ar- tery and prognosis. NT-proBNP, CysC and PCT were the important predictors in assessing prognosis for patients with ACS.
作者
刘洪军
杨猛
张开忠
Liu Hongjun Yang Meng Zhang Kaizhong.(Department of Cardiovascular Medicine, The Peoplers Hos- pital of Fengdu County, Fengdu 408200, Chin)
出处
《广西医科大学学报》
CAS
2017年第8期1145-1149,共5页
Journal of Guangxi Medical University
基金
重庆市卫生计生委医学科研课题资助项目(No.2015ZBXM093)
关键词
急性冠脉综合征
N末端脑钠肽前体
胱抑素C
PCT
预后
brainacute coronary syndrome
N-terminalnatriuretic peptide
cystatin C
procalcitonin
prognosis
