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目的:评价脑钠肽和不稳定型心绞痛和(或)非ST段抬高心肌梗死(UA/NSTEMI)患者冠状动脉(冠脉)病变程度的关系及脑钠肽对左主干狭窄的预测价值。方法:对资料完整的141例UA/NSTEMI按脑钠肽(BNP)水平分为4个百分位数组,BNP≤P25(78.0ng/L)组、P26～P50(78.1～26.5ng/L)组、P51～P75(265.1～368.0ng/L)组和>P75(368.0ng/L)组。对各组间不同冠脉病变支数的百分率进行χ2检验,以受试者工作曲线(ROC)来分析BNP预测左主干狭窄的临床意义。结果:>P75组冠脉3支病变比率显著高于≤P25组、P26～P50组和P51～P75组,而单支冠脉病变比率显著低于上述3组;Gensini积分随着4组的BNP水平升高亦增高,且>P75组显著高于≤P25组和P26～P50组。ROC分析示BNP用于判断左主干狭窄有显著意义(P<0.01),BNP水平越高则左主干狭窄的可能性越大;BNP水平为310ng/L时,其预测左主干狭窄的灵敏度为84.2%,特异度为70.5%。结论:在UA/NSTEMI患者中BNP水平越高,其冠脉病变程度越重,BNP可作为预测UA/NSETEMI患者左主干狭窄的一个有效指标。
Objective: To evaluate the relationship between the severity of coronary artery (coronary artery) disease and the predictive value of brain natriuretic peptide for left main stenosis in patients with brain natriuretic peptide and unstable angina and / or non-ST-segment elevation myocardial infarction (UA / NSTEMI). Methods: The data of 141 UA / NSTEMI patients were divided into 4 percentile groups according to BNP level: BNP≤P25 (78.0ng / L), P26 ~ P50 (78.1 ~ 26.5ng / L) Group, P51 ~ P75 (265.1 ~ 368.0ng / L) group and> P75 (368.0ng / L) group. The percentages of different coronary lesions in each group were determined byχ2 test, and the clinical significance of BNP in predicting left main stenosis was analyzed by receiver operating characteristic curve (ROC). Results: The ratio of 3 lesions in P75 group was significantly higher than those in ≤ P25 group, P26 - P50 group and P51 - P75 group, while the rate of single coronary artery lesion was significantly lower than those in the above three groups. The Gensini score was positively correlated with BNP Elevated levels also increased, and> P75 group was significantly higher than the ≤ P25 group and P26 ~ P50 group. ROC analysis showed that BNP was used to judge the left main stenosis (P <0.01). The higher the BNP level, the greater the possibility of left main stenosis. When BNP level was 310 ng / L, the sensitivity of predicted left main stenosis was 84.2 %, Specificity is 70.5%. Conclusions: The higher the BNP level in patients with UA / NSTEMI, the more severe the coronary artery lesions. BNP can be used as a valid predictor of left main stenosis in patients with UA / NSEEM.