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目的:初步探讨稳定型冠心病(CAD)患者静脉血浆B型利钠肽(BNP)水平在长期药物洗脱支架(DES)植入后的变化以及基线BNP水平与临床事件的关系。方法:研究入选了88例稳定CAD患者,均经冠脉造影(CAG)证实。以微粒子酶免分析法(化学发光法)测定所有入选者血BNP浓度。其中29例在DES植入后进行了CAG复查和BNP测定。随访1年时的死亡、非致死性急性冠脉综合征(ACS)、再次PCI、再次心血管原因入院等不良心血管事件。结果:BNP水平:冠脉造影Gensini评分>33组(44例)的显著高于Gensini评分≤33组(44例)的,P=0.0468。DES植入8月后BNP水平明显降低[(230.43±48.81)∶(149.33±17.49)pg/ml,P=0.0382]。平均随访10.5个月,BNP高水平组死亡、非致死性ACS、再入院和再次PCI率均显著高于低水平组(P=0.001)。结论:稳定CAD病变程度越重,BNP水平越高,而DES植入8月后BNP水平降低可能反映了心功能的改善;基线BNP水平对稳定CAD心血管事件可能有重要预测价值。
Objective: To investigate the changes of venous plasma BNP level in patients with stable coronary heart disease (CAD) after long-term drug-eluting stent (DES) implantation and the relationship between baseline BNP level and clinical events. Methods: The study enrolled 88 patients with stable CAD, confirmed by coronary angiography (CAG). Plasma BNP levels were determined by microparticle enzyme immunoassay (chemiluminescence). 29 of them underwent CAG and BNP after DES implantation. Follow-up at 1 year of death, non-fatal acute coronary syndromes (ACS), PCI again, admission of another cardiovascular cause adverse cardiovascular events. Results: BNP levels: Coronary angiography Gensini score> 33 (44 cases) was significantly higher than the Gensini score ≤ 33 group (44 cases), P = 0.0468. After 8 months of DES implantation, the level of BNP was significantly decreased [(230.43 ± 48.81) :( 149.33 ± 17.49) pg / ml, P = 0.0382]. After an average of 10.5 months of follow-up, BNP high-level death, nonfatal ACS, readmission and re-PCI rates were significantly higher than those of the low-level group (P = 0.001). Conclusions: The more severe the CAD lesions, the higher the BNP level. The decrease of BNP level after DES implantation may reflect the improvement of cardiac function. The baseline BNP level may have important predictive value for the stability of CAD cardiovascular events.