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目的研究急性心肌梗死患者早期N端脑钠肽前体(NT-proBNP)浓度及其与急性心肌梗死患者急性期心功能及其预后的关系。方法对25例初发的急性心肌梗死患者在24 h内及病程的第4周分别采血,测定患者血清NT-proBNP1及NT-proBNP2;根据患者心脏功能状况(Killip分级)分为两组:A组:Killip分级为Ⅰ级,B 组:Killip分级为Ⅱ～Ⅳ级,进行NT-proBNP浓度的比较。结果急性心肌梗死组早期的NT-proBNP浓度高于对照组,无明显心力衰竭的A组与对照组比较也得出类似的结果。有心力衰竭的心肌梗死患者与无明显心力衰竭的患者比较,其血清NT-proBNP1增高。死亡组与非死亡组的比较:死亡组患者有着较大的年龄和较高的NT- proBNP值。急性心肌梗死患者早期NT-proBNP浓度与其他变量的相关性研究:NT-proBNP与年龄、Killip分级呈正相关,与EF值呈负相关。结论急性心肌梗死患者早期血清NT-proBNP浓度与急性期心功能状态及预后密切相关,对急性心肌梗死患者测定其早期血清NT-proBNP浓度具有重要的临床意义。
Objective To investigate the relationship between the early NT-proBNP level and the cardiac function and prognosis in acute myocardial infarction patients with acute myocardial infarction. Methods Serum NT-proBNP1 and NT-proBNP2 were measured in 25 patients with newly diagnosed acute myocardial infarction within 24 hours and the fourth week of disease. According to the cardiac function status (Killip classification), the patients were divided into two groups: A Group: Killip grade Ⅰ, B group: Killip grade Ⅱ ~ Ⅳ, NT-proBNP concentrations were compared. Results The concentration of NT-proBNP in early AMI group was higher than that in control group. Similar results were found in A group with no obvious heart failure compared with control group. Patients with heart failure and myocardial infarction patients without significant heart failure, the serum NT-proBNP1 increased. Comparison of death and non-death groups: Patients in the death group had larger ages and higher NT-proBNP values. Correlation between NT-proBNP concentration and other variables in patients with acute myocardial infarction: NT-proBNP was positively correlated with age and Killip classification, and negatively correlated with EF. Conclusion The early serum NT-proBNP concentration in patients with acute myocardial infarction is closely related to the cardiac function and prognosis in acute stage. It is of great clinical significance to determine the serum NT-proBNP concentration in patients with acute myocardial infarction.