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目的:观察ST段抬高的急性心肌梗死(STEAMI)患者接受急诊直接冠状动脉介入治疗(PCI)后的脑利钠肽(BNP)水平对长期预后价值的应用。方法:连续入选2009年1月～2011年1月之间,发病后12小时之内接受急诊直接PCI治疗的ST段抬高的急性心肌梗死患者184例,采用荧光免疫抗原抗体结合方法测定发病后24小时血浆BNP水平。根据BNP浓度分为3组:A组<100pg/mL,B组100～400pg/mL,C组>400pg/mL。收集住院期间的临床资料,并随访1年。结果:①冠状动脉造影结果中B组、C组多支血管病变比例明显高于A组(P<0.01)。②1年内病死率C组明显高于A、B组(P<0.01),进行多因素logistic回归分析,血浆BNP浓度是AMI后1年病死率的独立预测因子。结论:接受急诊直接冠状动脉介入治疗的ST段抬高的急性心肌梗死患者的早期血浆脑利钠肽水平可作为1年后病死率的预测因子。
AIM: To investigate the long-term prognostic value of brain natriuretic peptide (BNP) levels in patients with ST-segment elevation acute myocardial infarction (STEAMI) undergoing direct-percutaneous coronary intervention (PCI). Methods: One hundred and eighty-four patients with acute ST-segment elevation myocardial infarction who received emergency PCI within 12 hours after onset were enrolled continuously from January 2009 to January 2011. Fluorescent antigen-antibody-antibody was used to measure the incidence of acute myocardial infarction 24-hour plasma BNP levels. According to BNP concentration, the patients were divided into 3 groups: group A <100pg / mL, group B 100 ~ 400pg / mL and group C 400pg / mL. Clinical data were collected during the hospital stay and followed up for 1 year. Results ① The proportions of MVD in group B and group C were significantly higher than those in group A (P <0.01). ② The mortality in one year was significantly higher in group C than in group A and B (P <0.01), and multivariate logistic regression analysis was used. The plasma BNP concentration was an independent predictor of mortality at 1 year after AMI. CONCLUSIONS: Early plasma brain natriuretic peptide levels in patients with ST-elevation acute myocardial infarction undergoing direct PCI may be used as predictors of mortality after 1 year.