文章摘要

文章信息/Info

Title:: Changes of plasma NT-proBNP levels and their clinical significance in coronary heart disease patients 6 months after percutaneous coronary intervention

作者:: 李婧; 董丽; 阿荣; 王悦喜; 内蒙古医学院第一附属医院心血管内科，内蒙古呼和浩特 010059

Author(s):: LI Jing; DONG Li; A Rong; WANG Yue-xi; Department of Cardiovascular Diseases, Affiliated Hospital, Inner Mongolia Medical College, Hohhot 010050, Inner Mongolia, China

关键词:: 经皮冠状动脉介入治疗; 氨基末端脑钠尿肽前体; 超声心动图

Keywords:: percutaneous coronary intervention; N-terminal pro-brain natriuretic peptide; echocardiography

分类号:: R541.4

DOI:: -

文献标识码:: A

摘要:: 目的: 观察冠心病患者行经皮冠状动脉介入治疗（PCI）前和6个月以后血浆中氨基末端脑钠尿肽前体（N-terminal pro-brain natriuretic peptide, NT-proBNP）水平的变化，探讨其临床意义和近期预后价值。方法: 将经冠状动脉造影（CAG）证实的71例冠心病患者，分为PCI组（51例）和对照组（20例），用电化学发光免疫分析法动态观察其血浆NT-proBNP浓度，分别比较PCI组术前、术后即刻、术后6 h、术后24 h和术后6个月血浆NT-proBNP水平的变化情况，以及随访期间PCI组与对照组患者血浆NT-proBNP浓度的变化。经超声心动图检测两组患者住院期间与术后6个月左心室舒张末期内径（LVEDD）和收缩末期内径（LVESD），室间隔（IVSW）与左室后壁厚度（LVPW），左室射血分数（LVEF），左室短轴缩短率（FS）及E/A比值以评价心功能。结果: PCI组术后6个月血浆Log NT-proBNP浓度［(2.0±0.5)ng/L］显著低于术前［(2.4±0.5)ng/L］水平（P<0.05）。对照组患者6个月后血浆Log NT-proBNP浓度［(2.5±0.6)ng/L］明显高于PCI组［(2.0±0.5)ng/L］（P<0.05）。比较超声心动图各项指标，PCI组患者术后6个月LVEF［(62±10)%］较术前［(64±10)%］有所下降（P<0.05）。结论: 冠心病患者行PCI术后6个月血浆NT-proBNP水平显著降低，提示血运重建与药物治疗联合可能优于单纯药物治疗，并且NT-proBNP对冠心病患者可能具有近期预后价值，可以指导临床医生早期干预，尽可能降低冠心病发病率和死亡率。

Abstract:: AIM: To observe the changes of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in coronary heart disease (CHD) patients before and 6 months after percutaneous coronary intervention (PCI) and to explore their clinical significance and prognostic value. METHODS: Seventy one patients with coronary heart disease confirmed by coronary angiography (CAG) were divided into PCI group (51 cases) and control group (20 cases). Dynamic plasma NT-proBNP concentrations were observed by electrochemiluminescence immunoassay and changes of plasma NT-proBNP concentrations in PCI group were evaluated preoperatively, immediately postoperatively and 6 h, 24 h and 6 months later. We compared the difference of plasma NT-proBNP concentrations between PCI group and control group. Both groups underwent echocardiography during hospitalization and 6 months later, respectively, to examine the left ventricular end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD), interventricular septal wall thickness (IVSW), left ventricular posterior wall thickness (LVPW), left ventricular ejection fraction (LVEF%), left ventricular fraction shortening (FS%) and E/A ratio for the evaluation of cardiac function. RESULTS: Plasma Log NT-proBNP concentrations 6 months after were significantly lower than the preoperative levels in PCI group ［(2.0±0.5) ng/L vs. (2.4±0.5) ng/L］(P<0.05). Plasma Log NT-proBNP plasma concentrations in control group 6 months after were significantly higher than those in PCI group ［(2.5±0.6)ng/L vs. (2.0±0.5)ng/L］(P<0.05). Comparison of echocardiographic indicators showed that LVEF% 6 months after was significantly lower than in preoperative PCI group ［(64±10)% vs.(62±10)%］ (P<0.05). CONCLUSION: Plasma NT-proBNP levels are significantly lower in coronary heart disease patients 6 months after PCI, indicating that revascularization is more effective than drug therapy.

参考文献/References

［1］ Ranjith N, Pegoraro RJ, Naidoo DP, et al. Prognostic value of N-terminal-pro-brain natriuretic peptide measurements in patients with acute coronary syndromes［J］. Cardiovasc J S Afr, 2006,17(2):60-66.

［2］ Puri A, Narain VS, Mehrotra S, et al. N-terminal probrain natriuretic peptide predicts adverse outcomes in acute-myocardial infarction even with preserved left ventricular ejection fraction［J］. Indian Heart J, 2006,58(2):138-143.

［3］ Blankenberg S, McQueen MJ, Smieja M, et al. Comparative impact of multiple biomarkers and N-Terminal pro-brain natriuretic peptide in the context of conventional risk factors for the prediction of recurrent cardiovascular events in the Heart Outcomes Prevention Evaluation (HOPE) Study［J］. Circulation, 2006,114(3):201-208.

［4］ Seino Y, Ogawa A, Yamashita T, et al. Application of NT-proBNP and BNP measurements in cardiac care: a more discerning marker for the detection and evaluation of heart failure［J］. Eur J Heart Fail, 2004, 6(3):295-300.

［5］李婧,王悦喜. CHD患者PCI术后血浆NT-proBNP水平变化的研究进展［J］. 心脏杂志, 2008, 20(06):783-785.

［6］ Loke I, Squire IB, Davies JE, et al. Reference ranges for natriuretic peptides for diagnostic use are dependent on age, gender and heart rate［J］. Eur J Heart Fail, 2003, 5(5):599-606.

［7］ Di Sciascio G, Patti G, DAmbrosio A, et al. Coronary stenting in patients with depressed left ventricular function: acute and long-term results in a selected population［J］. Catheter Cardiovasc Interv, 2003, 59(4):429-433.

我们的网站为什么显示成这样？

冠心病患者PCI术后6个月血浆NT-proBNP水平的变化及临床意义

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

文章信息/Info

参考文献/References

备注/Memo

常用功能

导航/Navigate

工具/Tools

统计/Statistics