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目的:探讨血清N末端脑钠肽前体(NT-pro BNP)及超敏C反应蛋白(hs-CRP)在预测急性ST段抬高性心肌梗死(STEMI)近期主要心脏不良事件(MACE)的价值。方法:选取172例STEMI患者为研究对象,按照住院期间是否发生MACE分为MACE组(n=56例)和非MACE组(n=116例),记录两组之间的入院时血清NT-pro BNP及hs-CRP水平及一般临床资料及实验室检查指标,将NT-pro BNP及hs-CRP水平按照四分位分组(Q_1、Q_2、Q_3和Q_4组),比较各组相关指标的差异,用多因素Logistic回归模型分析NT-pro BNP及hs-CRP水平与MACE发生的关系,用ROC曲线评价血清NT-pro BNP及hs-CRP预测MACE发生的价值。结果:MACE组和非MACE组在血清NT-pro BNP及hs-CRP存在显著的统计学差异(P<0.05),MACE组两指标高于非MACE组;两者四分位分组之间MACE发生率存在统计学差异(P<0.05),NT-pro BNP Q_4组和hs-CRP Q_4组中的MACE发生率高于NT-pro BNP Q_1~Q_2组及hs-CRP Q_1~Q_2组;多因素Logistic回归分析显示血清NT-pro BNP及hs-CRP是STEMI患者近期MACE发生的独立危险因素,且NT-pro BNP Q_1~Q_4组及hs-CRP Q_1~Q_4组之间风险值(OR)逐渐增大。ROC曲线提示血清NT-pro BNP及hs-CRP预测MACE发生的ROCACU分别为:0.887、0.797;灵敏度分别为91.1、85.6;特异度分别为82.6、75.2。结论:血清NT-pro BNP及hs-CRP可能是STEMI患者近期MACE发生的独立危险因素,应当引起临床重视。
Objective: To investigate the relationship between serum N-terminal pro-brain natriuretic peptide (BNP) and hs-CRP in the prediction of major adverse cardiac events (MACE) in patients with acute ST-segment elevation myocardial infarction value. Methods: A total of 172 patients with STEMI were enrolled in this study. MACE patients (n = 56) and non-MACE patients (n = 116) were enrolled in this study. Serum NT-pro BNP and hs-CRP levels and general clinical data and laboratory test indicators, the levels of NT-pro BNP and hs-CRP were divided into quartiles (Q_1, Q_2, Q_3 and Q_4 groups) Multivariate Logistic regression model was used to analyze the relationship between NT-pro BNP and hs-CRP levels and the occurrence of MACE. The ROC curve was used to evaluate the predictive value of serum NT-pro BNP and hs-CRP in MACE. Results: There was a significant difference in serum NT-pro BNP and hs-CRP between MACE group and non-MACE group (P <0.05), MACE group was higher than non-MACE group; MACE occurred between the two quartiles (P <0.05). The incidence of MACE in NT-pro BNP Q_4 group and hs-CRP Q_4 group was higher than that in NT-pro BNP Q_1 ~ Q_2 group and hs-CRP Q_1 ~ Q_2 group. Multivariate logistic regression Regression analysis showed that serum NT-pro BNP and hs-CRP were independent risk factors of recent MACE in STEMI patients, and the risk (OR) value of NT-pro BNP Q_1 ~ Q_4 group and hs-CRP Q_1 ~ Q_4 group increased gradually . The ROC curves of ROC curve predicted by serum NT-pro BNP and hs-CRP predictive MACE were 0.887 and 0.777, respectively; the sensitivity was 91.1 and 85.6 respectively; the specificity was 82.6 and 75.2 respectively. Conclusion: Serum NT-pro BNP and hs-CRP may be independent risk factors for recent MACE in STEMI patients, and should be clinically valued.