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目的探讨N-末端脑利钠钛原(NT-proBNP)对冠状动脉病变进展和支架内再狭窄的预测价值。方法测定303例左心室收缩功能(射血分数>50%)正常的慢性稳定性心绞痛患者入院时及随访时的血浆NT-proBNP浓度。所有患者于支架植入术后6-9个月行造影随访。结果进展组患者入院时NT-proBNP浓度高于非进展组患者(455fmol/ml vs431fmol/ml,P=0.017)。多元回归分析显示入院时血浆NT-proBNP可独立预测冠状动脉非靶病变造影显示的快速进展(OR=1.944,95%CI1.047-3.608,P=0.035)。NT-proBNP水平与靶病变支架内再狭窄无关。结论入院时血浆NT-proBNP是左心室功能正常的稳定性心绞痛患者冠状动脉病变进展而非再狭窄的独立预测因子。
Objective To investigate the predictive value of NT-proBNP on the progression of coronary artery disease and in-stent restenosis. Methods Plasma concentrations of NT-proBNP were measured at admission and at follow-up in 303 patients with stable chronic left ventricular systolic function (ejection fraction> 50%). All patients underwent angiographic follow up 6-9 months after stenting. Results Patients in the progression group had higher levels of NT-proBNP at admission than those in the non-progression group (455 fmol / ml vs 431 fmol / ml, P = 0.017). Multivariate regression analysis showed that plasma NT-proBNP on admission could independently predict the rapid progression of non-target coronary angiography (OR = 1.944, 95% CI 1.047-3.608, P = 0.035). The level of NT-proBNP was not associated with in-stent restenosis in the target lesion. Conclusions Plasma NT-proBNP at admission is an independent predictor of progression of coronary lesions rather than restenosis in patients with stable left ventricular dysfunction.