血清NT-proBNP、UA/Cr联合检测对UAP患者发生AMI的预测价值

doi:10.3969/j.issn.1671-7171.2023.02.023

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摘要【目的】探讨不稳定型心绞痛(UAP)患者血清氨基末端B型脑钠肽前体(NT-proBNP)、尿酸(UA)/肌酐(Cr)与冠心病严重程度的关系及对急性心肌梗死(AMI)发病的预测价值。【方法】本院收治的127例UAP患者为研究对象,对比不同严重程度UAP患者血清NT-proBNP、UA/Cr水平。随访1个月,统计UAP患者AMI发生情况,并依据是否发生AMI分为发生组(23例)和未发生组(104例)。比较两组患者的临床资料,采用Logistic多因素回归分析影响UAP患者发生AMI的危险因素,绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评价血清NT-proBNP、UA/Cr对UAP患者发生AMI的预测效能。【结果】重度组UAP患者血清NT-proBNP、UA/Cr均高于轻度组和中度组(P<0.05);中度组UAP患者血清NT-proBNP、UA/Cr高于轻度组(P<0.05)。发生组冠心病重度占比、心脏肌钙蛋白I (cTnI)、同型半胱氨酸、UA、NT-proBNP及UA/Cr高于未发生组(P<0.05),左室射血分数(LVEF)则低于未发生组(P<0.05)。多因素分析结果显示,病情为重度、LVEF、cTnI、NT-proBNP及UA/Cr均为影响发生UAP患者AMI的危险因素(均P<0.05)。ROC分析显示,血清NT-proBNP、UA/Cr及两者联合检测对UAP患者发生AMI预测的灵敏度分别为69.57%、73.91%、79.52%,特异度分别为79.81%、74.04%、98.08%,AUC分别为0.721、0.770、0.901。【结论】UAP患者血清NT-proBNP、UA/Cr与冠心病严重程度及AMI发病有关,且两者联合检测对UAP患者发生AMI的预测效能较高。

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关键词 ：心绞痛, 不稳定型, 心肌梗死, 急性病, 利钠肽,脑/血液, 尿酸/血液

Abstract：【Objective】To investigate the relationship of serum amino-terminal precursor B-type brain natriuretic peptide (NT-proBNP) and uric acid (UA)/creatinine (Cr) with the severity of coronary heart disease in patients with unstable angina pectoris (UAP),and evaluate the predictive value of acute myocardial infarction (AMI) morbidity with NT-proBNP combined Cr measurement. 【Methods】A total of 127 UAP patients admitted to the hospital were selected as the research objects. The serum NT-proBNP and UA/Cr of patients with different severity of UAP were compared. Follow-up for 1 month,the occurrence of AMI in UAP patients was counted. Patients were divided into the occurrence group (23 cases) and the non-incident group (104 cases) according to whether AMI occurred or not. The clinical data of the patients in the occurrence group and the non-occurrence group were compared. Logistic multivariate regression was used to analyze the risk factors for AMI in UAP patients. The area under the curve (AUC) of receiver operating characteristic curve (ROC) was drawn to evaluate the predictive performance of serum NT-proBNP and UA/Cr on the occurrence of AMI in UAP patients. 【Results】Serum NT-proBNP and UA/Cr of UAP patients in the severe group were higher than those in the mild and moderate groups (P<0.05). The serum NT-proBNP and UA/Cr of UAP patients in the moderate group were higher than those in the mild group (P<0.05). The proportion of severe coronary heart disease,cardiac troponin I (cTnI),homocysteine,UA,serum NT-proBNP and UA/Cr in the AMI occurrence group were higher than those in the AMI non-occurrence group (P<0.05),while the left ventricular ejection fraction (LVEF) was lower in the non-occurrence group (P<0.05). Multivariate analysis showed that the disease was the disease severity,LVEF,cTnI ,NT-proBNP and UA/Cr were all risk factors for the occurrence of AMI in UAP patients (P<0.05). The results of ROC curve analysis showed that the sensitivity of serum NT-proBNP,UA/Cr alone and their combined detection to predict the occurrence of AMI in UAP patients was 69.57%,73.91% and 79.52%,respectively; And the specificity was 79.81%,74.04% and 98.08%,respectively. The AUC were 0.721,0.770 and 0.901,respectively. 【Conclusion】The serum NT-proBNP and UA/Cr of UAP patients are related to the severity of coronary heart disease and the incidence of AMI. The combination of NT-proBNP and UA/Cr of UAP detection has a higher predictive performance for the incidence of AMI in UAP patients.

Key words： Angina, Unstable Myocardial Infarction Acute Disease Natriuretic Peptide, Brain/BL Uric Acid/BL

收稿日期: 2022-10-12

中图分类号:

R541.42

通讯作者: *E-mail:huanglei520111@163.com

引用本文:

吴晶晶, 陈润祥, 廖占玲, 安国印, 郭洁. 血清NT-proBNP、UA/Cr联合检测对UAP患者发生AMI的预测价值[J]. 医学临床研究, 2023, 40(2): 241-244.
WU Jing-jing, CHEN Run-xiang, LIAO Zhan-ling,et al. Application of the Combination of Serum NT-proBNP and UA/Cr in Predicting the Incidence of AMI in UAP Patients. JOURNAL OF CLINICAL RESEARCH, 2023, 40(2): 241-244.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.02.023 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I2/241

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