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[目的]分析氨基末端B型脑钠肽前体(NT-proBNP)对急性冠脉综合征(ACS)患者中期心源性病死的预测价值.[方法]选择2014年10月至2015年8月由本院急诊收住的364例ACS患者的临床资料,入院后1～3d抽取其静脉血,检查其NT-proBNP水平及肌钙蛋白(cTnT或cTnI)水平;行超声心动图检查患者左心室舒张末内径(LVEDD)、左室射血分数(LVEF).通过门诊或电话对患者进行随访24个月,记录心源性病死情况.[结果]入选病例343例,ST段抬高性心肌梗死(STEMI)148例,急性非ST段抬高性心肌梗死(NSTEMI)54例,不稳定性心绞痛(UA)141例.STEMI组、NSTEMI组、UA组在年龄、合并高血压、合并高胆固醇血症、LVEF、InNT-proBNP、cTnT或cTnI阳性率方面比较差异具有统计学意义(P＜0.05).根据是否为心源性病死将其分为病死组(n＝20)和生存组(n＝321),病死组年龄、cTnT或cTnI阳性率、LVEF、InNT-proBNP与生存组比较,差异均具有统计学意义(P＜0.05).NT-proBNP是心源性病死的独立预测因子(P＜0.05),其ROC曲线下面积为0.773(P＝0.000).根据ROC曲线将NT-proBNP最佳阈值点定为1269fmol/mL时,其准确性最高为82.5％.[结论]NT-proBNP可较好预测急性冠脉综合征患者中期心源性病死情况.“,”[Objective]To analyze the predictive value of NT-proBNP in patients with acute coronary syndrome(ACS).[Methods]From October 2014 to August 2015,the clinical data of 364 patients with ACS were collected from our hospital.The venous blood was taken from them 1～3 days after admission,and the levels of NT-proBNP and tropo-nin cTnT or cTnI were examined.Left ventricular end-diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were examined by echocardiography.Patients were followed up for 24 months by outpatient or telephone to re-cord cardiac death.[Results]Among the 343 patients,there were 148 cases of ST-segment elevation myocardial infarction(STEMI),54 cases of acute non-ST-segment elevation myocardial infarction(NSTEMI)and 141 cases of unstable angina pectoris(UA).There were significant differences in the positive rate of age,hypertension,hypercholesterolemia,LVEF,InNT-proBNP,cTnT or cTnI between the STEMI group,the NSTEMI group and the UA group(P ＜0.05).According to whether they died of cardiogenic disease,they were divided into two groups :the death group(n＝20)and the survival group(n ＝321).The positive rate of cTnT or cTnI in the death group was significantly higher than that in the survival group(P ＜0.05).The age,positive rate of cTnT or cTnI,LVEF and InNT-proBNP in the dead group were signifi-cantly higher than those in the survival group(P ＜0.05).NT-proBNP was an independent predictor of cardiac death(P＜0.05),the area under ROC curve was 0.773(P ＝0.000).When the optimum threshold point of NT-proBNP was set at 1269 fmol/mL according to the ROC curve,the highest accuracy was 82.5％.[Conclusion]NT-proBNP is a good predictor of mid-term cardiac death in patients with acute coronary syndrome.