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目的：探讨急性心肌梗死（AMI）患者血浆N 末端B 型尿钠肽前体（NT-proBNP）的水平与心肌缺血及预后的关系。方法：98 例急性心肌梗死患者根据患者是否行直接PCI 手术治疗，分为PCI 手术治疗组和非PCI 治疗组，观察缺血改善情况与NT-proBNP 水平的关系，同时根据治疗后NT-proBNP 的水平分为三组，A 组NT-proBNP<125pg/ml、B 组125pg/ml≤NT-proBNP<450pg/ml、C 组 NT-proBNP≥450pg/ml，观察NT-proBNP 的水平与预后的关系。结果：行PCI 组NT-proBNP 的水平下降程度（438.3±134.5）明显高于未行PCI 组者（158.6±146.1，P<0.05），MACE 的发生情况C 组明显高于A 组（P=0.006＜0.01），也高于B 组（P=0.028＜0.05），A 组与B 组相比，B 组的MACE 发生率有上升的趋势，但是无统计学意义（P=0.432＞0.05）。结论：急性心肌梗死患者早期血浆 NT-proBNP 的水平在一定程度上可以反应心肌的缺血程度，且与患者的预后成明显的负相关。

英文摘要:

Objective: To study the relationship between plasma N-terminal pro-B-type natriuretic (NT-proBNP) levels and myocardial ischemia , prognosis in Acute myocardial infarction (AMI) patients. Methods: According to the patients whether underwent primary PCI operation ,98 AMI patients were divided into surgical PCI treatment group and the non-PCI treatment group, to observe the association improved schemia situation with NT-proBNP level, meanwhile according to the levels of the NT-proBNP after treatment ,the patients were divided into three groups, including A group（NT-proBNP＜125pg/ml), B group (125pg/ml≤NT-proBNP＜450pg/ml) and C group (NT-proBNP≥450pg/ml), to observe the relationship between the levels of the NT-proBNP and prognosis. Results: The NT-proBNP levels in PCI treatment group decreased significantly （438.3±134.5）compared with non-PCI treatment group (158.6 ± 146.1, P＜0.05), The incidence ofMACE in group C was significantly higher than group A (P = 0.006＜0.01), also higher than the B group（P=0.028＜0.05）, The incidence of MACE in group B was higher than group A, but the two groups no significant difference in meaning. Conclusions: AMI patients with early plasma NT-proBNP levels Can reflect the degree of myocardial ischemia to some extent, and have a significant negative correlation to prognosis of the patient.

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