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目的观察血浆氨基末端脑钠肽前体(NT-proBNP)在急性非ST段抬高型心肌梗死(ANSTEMI)患者中的变化及与预后的关系。方法选择以胸痛就诊接受冠状动脉造影术的患者192例,其中ANSTEMI组78例,不稳定型心绞痛组(UA)76例,冠状动脉造影正常者38例作为对照组。所有患者在就诊后即刻测NT-proBNP浓度、肌钙蛋白(cTnI)浓度;造影前及造影后2个月分别查超声心动图测定患者左室射血分数(LVEF)及左室舒张末内径(LVEDD)。结果与对照组比较,ANSTEMI组和UA组的NT-proBNP及cTnI水平显著升高,LVEDD值明显增高,LVEF明显降低,差异有统计学意义(P﹤0.05);NT-proBNP水平与肌钙蛋白浓度和左室舒张末内径呈正相关,与左室射血分数呈负相关。结论NT-proBNP可以作为急性非ST段抬高型心肌梗死患者近期心功能的预测因子,可以预测患者的预后。
Objective To observe the changes of plasma NT-proBNP in patients with acute non-ST-segment elevation myocardial infarction (ANSTEMI) and its relationship with prognosis. Methods A total of 192 patients undergoing coronary angiography with chest pain were selected. Among them, 78 were in the ANSTEMI group, 76 were in the unstable angina group (UA), and 38 were normal coronary angiography as the control group. All patients were examined immediately after treatment NT-proBNP concentration, troponin (cTnI) concentration; 2 months after angiography and contrast echocardiography were measured in patients with left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter LVEDD). Results Compared with the control group, the levels of NT-proBNP and cTnI in the ANSTEMI group and the UA group were significantly increased, the LVEDD value was significantly increased, LVEF was significantly lower, the difference was statistically significant (P <0.05); NT-proBNP level and troponin The concentration and left ventricular end-diastolic diameter was positively correlated with left ventricular ejection fraction was negatively correlated. Conclusion NT-proBNP can be used as a predictor of recent cardiac function in patients with acute non-ST-segment elevation myocardial infarction and can predict the prognosis of patients.