| 吴雨径 刘惠亮 李屹 张蛟 魏玉杰.血清NT-proBNP 与hs-CRP在预测急性ST段抬高性心肌梗死主要心脏
不良事件的价值[J].,2016,16(17):3317-3321 |
| 血清NT-proBNP 与hs-CRP在预测急性ST段抬高性心肌梗死主要心脏
不良事件的价值 |
| Clinical Value of SerumNT-proBNP and hs-CRP in Predicting MajorAdverse Cardiac Events for Patient with Acute ST-segment ElevationMyocardial Infarction |
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| DOI： |
| 中文关键词: ST 段抬高性心肌梗死 N末端脑钠肽前体 超敏C反应蛋白 主要心脏不良事件 |
| 英文关键词: St-elevation myocardial infarction N terminal brain natriuretic peptide precursor Hypersensitive c-reactive protein Major
adverse cardiac events |
| 基金项目:卫生部医药卫生科技发展项目（W2013GJ09） |
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| 中文摘要: |
| 目的：探讨血清N 末端脑钠肽前体(NT-proBNP)及超敏C 反应蛋白(hs-CRP)在预测急性ST 段抬高性心肌梗死(STEMI)近期
主要心脏不良事件(MACE)的价值。方法：选取172 例STEMI 患者为研究对象，按照住院期间是否发生MACE 分为MACE 组
(n=56 例)和非MACE 组(n=116 例)，记录两组之间的入院时血清NT-proBNP 及hs-CRP 水平及一般临床资料及实验室检查指标，
将NT-proBNP 及hs-CRP水平按照四分位分组(Q1、Q2、Q3和Q4组)，比较各组相关指标的差异，用多因素回归模型分析
NT-proBNP 及hs-CRP水平与MACE发生的关系，用ROC 曲线评价血清NT-proBNP 及hs-CRP 预测MACE 发生的价值。结
果：MACE 组和非MACE 组在血清NT-proBNP 及hs-CRP存在显著的统计学差异(P＜0.05)，MACE 组两指标高于非MACE 组；
两者四分位分组之间MACE 发生率存在统计学差异(P＜0.05)，NT-proBNP Q4组和hs-CRP Q4 组中的MACE 发生率高于
NT-proBNP Q1～Q2组及hs-CRP Q1～Q2组；多因素回归分析显示血清NT-proBNP 及hs-CRP 是STEMI患者近期MACE
发生的独立危险因素，且NT-proBNP Q1～Q4组及hs-CRP Q1～Q4组之间风险值(OR)逐渐增大。ROC 曲线提示血清NT-proBNP
及hs-CRP 预测MACE 发生的ROCACU 分别为：0.887、0.797；灵敏度分别为91.1、85.6；特异度分别为82.6、75.2。结论：血清
NT-proBNP及hs-CRP 可能是STEMI患者近期MACE 发生的独立危险因素，应当引起临床重视。 |
| 英文摘要: |
| Objective:To investigate the clinical value of serum NT-proBNP and hs-CRP in predicting major adverse cardiac
events (MACE) in patient with acute ST-segment elevation myocardial infarction (STEMI).Methods:Select 172 STEMI patients of our
hospital as the research object. According to whether they had MACE during hospital stay, they were divided into MACE group (n=56
cases) and the non-MACE group (n=116). Record the NT-proBNP and hs-CRP serumlevels, general clinical data and laboratory examination
indexes on admission. Then patients were subdivided into four groups according to the NT-proBNP and hs-CRP levels quarterback
(Q1, Q2, Q3and Q4 group). Compare the difference of related indicators between the groups. Multivariable logistic regression model was
applied to analyze the relationship of NT-proBNP and hs-CRP levels with MACE. ROC curve was applied to evaluate the value of serum
NT-proBNP and hs-CRP levels in predicting occurrence of MACE.Results:The NT-proBNP and hs-CRP serum levels had statistically
significant differences between MACE group and non-MACE group (P<0.05). MACE group had the two index higher than the
non-MACE group. The incidence of MACE had statistical differences between quarterback groups (P<0.05). The incidence of MACE
was higher in the NT-proBNP Q4 group and hs-CRP Q4 group than in the NT-proBNP Q1~Q2 groups and hs-CRP Q1~Q2 groups. Multiariable
Logistic regression analysis showed that the serumNT-proBNP and hs-CRP were independent risk factors for recent MACE of STEMI
patients, and the value at risk (OR) increased gradually between NT-proBNP Q1~Q4 groups and hs-CRP Q1~Q4 groups. ROC curve
suggested that the MACE prediction ROCACU of serum NT-proBNP and hs-CRP were respectively 0.887 and 0.797, and the sensitivity
respectively 91.1 and 85.6, and specific degree respectively 82.6 and 75.2.Conclusion:Serum NT - proBNP and hs - CRP may be independent
risk factors for STEMI patients with recently occurred MACE. |
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