山东医药2017，Vol.57Issue(31)：17-20,4.DOI:10.3969/j.issn.1002-266X.2017.31.005
不同部位AMI患者发病48 h内血浆BNP水平变化及其对近期并发心力衰竭的预测价值
Dynamic changes of plasma BNP levels within 48 h in patients with acute myocardial infarction at different sites and their predictive value for recent concurrent heart failure
摘要
Abstract
Objective To observe the dynamic changes of plasma brain natriuretic peptide (BNP) levels within 48 h from the onset of acute myocardial infarction (AMI) at different sites in patients and to explore their predictive values for recent concurrent heart failure (HF).Methods According to the infarction sites, 70 patients with AMI who underwent emergency percutaneous coronary intervention (PCI) within 12 hours from AMI onset were divided into the anterior wall group (n=41) and non-anterior wall group (n=29).And the levels of plasma BNP were compared within 1 h after PCI and at 12, 20, 24, and 48 h after AMI onset (T1-T5, respectively).The incidence of HF during hospitalization was recorded.The predictive value of BNP at each time point for the recent concurrent HF was determined by using the receiver operating characteristic (ROC) curve.Results Compared with the non-anterior wall group, the level of plasma BNP was higher than that in the anterior wall group at T1-T4.The levels of plasma BNP at T2-T5 in each of the two groups increased as compared with that at T1.The levels of plasma BNP at T3 and T4 in each of the two groups increased as compared with that at T2.The levels of plasma BNP at T5 in each of the two groups decreased as compared with that at T3 and T4 (all P<0.05).ROC curve analysis showed that, in the anterior wall group, the areas under the curve (AUC) of the BNP levels in predicting AMI complicated with HF during hospitalization at T1-T5 were 0.800, 0.831, 0.831, 0.835, and 0.885, respectively.The maximum AUC was at T5, its best cutoff value of BNP was 169.6 pg/mL, and its sensitivity and specificity were 92.3% and 70.0%, respectively.In non-anterior wall group, the AUC of the BNP levels in predicting AMI complicated with HF during hospitalization at T1-T5 were 0.653, 0.801, 0.847, 0.784, and 0.761, respectively.The maximum AUC was at T3, its best cutoff value of BNP was 178.5 pg/mL, and its sensitivity and specificity were 100.0% and 68.7%, respectively.Conclusions Within 48 h after AMI onset, BNP level first increases fast and then decreases slowly, and it reaches the peak at 20-24 h after AMI onset.The predictive value of BNP at different sites of AMI is different at different time points.The predictive value of BNP at 48 h after AMI onset is the highest in predicting AMI complicated with HF in the anterior AMI, and the predictive value of BNP at 20 h is the highest for non-anterior AMI.关键词
急性心肌梗死/脑钠肽/心力衰竭Key words
acute myocardial infarction/brain natriuretic peptide/heart failure分类
医药卫生引用本文复制引用
李慧娣,向定成,张金霞,肖华,易绍东,李爱敏,龙锋..不同部位AMI患者发病48 h内血浆BNP水平变化及其对近期并发心力衰竭的预测价值[J].山东医药,2017,57(31):17-20,4.基金项目
广东省信息产业发展专项基金(粤经信[2014]975号) （粤经信[2014]975号）
广州市科技计划专项(2014Y2-00068) （2014Y2-00068）
广州市科技计划产学研专项(201508020043) （201508020043）
广州市重点实验室建设专项(穗科信字[2013]163-15号). （穗科信字[2013]163-15号）
