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目的通过测定急性冠脉综合征(ACS)患者血浆N末端前脑钠肽(NT-pro BNP)和P选择素水平,探讨其与ACS病变严重程度及预后的关系.方法 选择2017年7月—2018年3月因急性胸痛住院并进行冠状动脉造影检查的患者238例,根据冠状动脉造影结果、心电图及心肌酶结果将患者分为3组:非ACS组(36例)、不稳定型心绞痛组(115例)和急性心肌梗死组(87例).测定各组患者血浆NT-pro BNP及P选择素水平.根据冠脉造影结果,以Gensini评分评价冠脉狭窄程度,记录冠脉病变支数.对于ACS患者(不稳定型心绞痛组和急性心肌梗死组)随访6个月,追踪主要心血管不良事件(MACE)(包括不稳定型心绞痛、心肌梗死及心源性猝死)的发生.通过统计分析,探索NT-pro BNP及P选择素水平在各组间的差异,与Gensini评分及冠脉病变支数的关系,以及与MACE发生的关系.结果共有6例ACS患者失访(3%).不稳定型心绞痛组和急性心肌梗死组NT-pro BNP和P选择素水平均高于非ACS组(P<0.05);急性心肌梗死组的NT-pro BNP和P选择素水平高于不稳定型心绞痛组(P<0.05).在ACS患者中,NT-pro BNP和P选择素水平与Gensini评分呈正相关(P<0.05),与冠脉病变支数无相关性(P＞0.05).根据出院6个月内是否发生MACE对患者分亚组进行分析, MACE亚组NT-pro BNP及P选择素水平均高于未发生MACE亚组(P<0.05).结论 血浆NT-pro BNP和P选择素水平对于ACS患者的严重程度及6个月内发生MACE可能具有重要的提示意义.“,”Objective To explore the relationship between the biomarkers and severity of coronary artery disease as well as major adverse cardiac events (MACE) through analyzing the levels of NT-pro brain natriuretic peptide (NT-pro BNP) and P selectin in patients with acute coronary syndrome (ACS). Methods 238 patients who were hospitalized for acute chest pain and underwent coronary angiography between July 2017 and March 2018 were selected. According to angiography, ECG and cardiac enzymes, patients were divided into 3 groups: non-ACS group (n=36), unstable angina group (n=118) and acute myocardial infarction group (n=87). The levels of plasma NT-pro BNP and P selectin were measured in all groups. Accord?ing to coronary angiography, the degree of stenosis was evaluated by Gensini score and the numbers of coronary artery le?sions were recorded. ACS patients (unstable angina group and acute myocardial infarction group) were followed up for 6 months to track MACE. The database was established by epidate, and SPSS 13.0 software package was used for statistical analysis to explore the differences of NT-pro BNP and P selectant levels between groups, and the relationship between bio?markers and Gensini score, the number of coronary artery lesions, and MACE within 6 months follow-up respectively. Re?sults A total of 6 ACS patients were lost to follow-up, with a loss rate of 3%. The levels of NT-pro BNP and P selectin in the unstable angina group and acute myocardial infarction group were higher than those in non-ACS group (P<0.05). The lev?els of NT-pro BNP and P selectin in the acute myocardial infarction group were also higher than those in unstable angina group (P<0.05). In ACS patients, NT-pro BNP and P selectant levels were significantly positively correlated with Gensini score (P<0.05), but not significantly correlated with the number of coronary artery lesions (P＞0.05). Subgroup analysis of patients according to whether MACE events occurred within 6 months after discharge showed that the levels of NT-pro BNP and P selectin in the MACE subgroup were significantly higher than those in the non-MACE subgroup (P<0.05). Conclu? sion Plasma NT-pro BNP and P selectin levels may have important implications for the severity of ACS and the occurrence of MACE within 6 months.