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目的：探讨氨基末端B 型钠尿肽原（NT-proBNP）在胸闷胸痛患者发生心血管死亡事件中的预测价值。方法：对我院2006 年 1 月至2015 年6 月因胸闷胸痛入院治疗的290 例患者进行随访调查，根据是否死亡或再入院进行分组，分为死亡组（9 例）和非死亡组（281 例）及再入院组（67 例）和非再入院组（223 例）。分别比较各组患者的基本资料、血清学指标，并针对结果进行Logistic 回归和受试者工作曲线（ROC）分析。结果：死亡组和再入院组患者的NT-proBNP水平均高于未死亡组和未再入院组（P<0.05）； NT-proBNP 是心血管事件死亡的影响因素（OR=1.96，95%CI：1.13～3.37），其中年龄校正后，NT-proBNP 对心血管事件死亡的影响无统计学意义（P>0.05）；性别、多支病变、支架植入、cTnT、Lp(a)及CK因素调整后，NT-proBNP 对因心血管事件死亡均存在促进作用（OR>1, P<0.05）；NT-proBNP 的曲线下面积（AUC）为0.721（95%CI：0.510～0.921）。结论：NT-proBNP 在胸闷胸痛患者发生心血管死亡事件中具有一定的预测价值，NT-proBNP 水平越高，发生心血管死亡事件的风险越高。

英文摘要:

Objective:To explore the prediction value of N-terminal pro-B type natriuretic peptide (NT-proBNP) in cardiovascular death events of patients with chest distress and chest pains.Methods:A total of 290 patients with chest distress and chest pains,who were treated in Hejian People's Hospital of Hebei Province from January 2006 to June 2015, were divided into dead group (n=9), non-dead group(n=281); meanwhile, return group(n=67) and non-return group(n=223). The general information and serological indexes between the two groups were compared,then Logistic regression and receiver operator curve(ROC) analysis were conducted.Results:The levels of NT-proBNP in the dead group and the return group were all higher than the non-dead group and non-return group (P<0.05). NT-proBNP was the risk factor of cardiovascular death events (OR=1.96, 95%CI: 1.13～3.37). When age was corrected, NT-proBNP had no influence on cardiovascular death events,but when gender, multivessel damage, stent implantation, cTnT, Lp (a)and CK were all corrected, the NT-proBNP had a promotion effect on the cardiovascular death events (OR>1, P<0.05). The area under ROC curve(AUC) of NT-proBNP was 0.721 (95% CI: 0.510～0.921).Conclusion:The level of NT-proBNP has prediction value in cardiovascular death events of patients with chest distress and chest pains; The higher level of NT-proBNP, the higher risk of cardiovascular death events.

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