血浆脑钠肽对不同年龄急性冠脉综合征患者介入治疗术后临床预后的意义

目的：探讨并比较血浆脑钠肽（BNP）对不同年龄组急性冠脉综合征（ACS）患者经皮冠脉介入（PCI）术后临床主要不良心脏事件（MACE）的预测价值。方法：回顾分析2007年12月至2010年3月因ACS在我院行PCI的患者，分为260岁和〈60岁两组，入院常规检验BNP，随访住院期间及出院后6个月内MACE（包括死亡、心源性休克、再发心绞痛、非致命性再次心肌梗死、非致命性心力衰竭、心律失常、靶血管血运重建、再次入院复合终点）的发生情况。结果：随访269例260岁患者，失访7例（2．6％），118例〈60岁患者，失访3例（2．5％），262例≥60岁患者的年龄与BNP水平显著正相关（r=0．368，P〈0．01），而115例〈60岁患者无显著相关性（r=-0．014，P〉0．05）。年龄≥60岁患者BNP水平与〈60岁患者比较，差异显著（P〈0．01），年龄260岁患者MACE与〈60岁患者比较，差异显著（P〈0．01），两组患者BNP水平与LVEF呈显著负相关（P均〈0．01）。多因素logistic回归分析显示：BNP可独立预测两组患者住院期间及出院后6个月内MACE（≥60岁OR=4．369P〈0．01；〈60岁OR=7．773P〈0．01）发生率。两组患者BNP水平对MACE预测的ROC曲线结果比较，差异无统计学意义（P〉0．05）。结论：不同年龄患者BNP水平及MACE发生率存在差异，但年龄并不影响BNP对ACS患者临床预后的预测价值。

The Clinical Prognostic Significance of Plasma Brain Natriuretic Peptide in Different Age Patients With Acute Coronary Syndromes Underwent Percutaneous Coronary Intervention

Objective： To investigate and compare the clinical prognostic value of major abnormal cardiac events （MACE） in different age groups of acute coronary syndrome （ACS） patients after percutaneous coronary intervention （PCI）by plasma brain natriuredc peptide （BNP）. Methods： Reteospective analysis ACS patients after PCI from December 2007 to March 2010 in our hospital who were divided into two age groups between 〉 60 -year-old and 〈60-year-old, to routine test BNP and follow-up MACE （including death, cardiogenic shock, recurrent angina pectoris, non-fatal re-infarction, non-fatal heart failure,arrhythmia, target vessel revascularization, re-ad- miRed to hospital composite end point） during hospitalization and within 6 months after discharge from hospital. Resttlts： Follow-up 269 patients whose age ≥ 60 -year-old, lost 7 cases （2.6%）, 118 patients whose age 〈60-year-old had lost 3 （2.5%）, 262 patients 〉 60-year-old between age and BNP levels were significantly positively correlated （r=0.368 P 〈0.01 ）;while 115 cases whose age 〈60-year-old between age and BNP levels were no significant correlation （r=-0.014 P〉0.05 ）. The difference of BNP levels compared between age ≥ 60 -year-old and age〈60-year-old was significant （P 〈0.01）. The difference of MACE compared between age -〉 60 -year-old and age〈60-year-old was significant （P 〈0.01）. Two groups of patients with BNP levels and LVEF was significantly negatively correlated（both P〈0.01 ）. Multivariate logistic regression analysis showed that BNP may be independent predict MACE（≥ 60-year-old OR=4.369 P〈0.01 ; 〈60-year-old OR=7.773 P〈0.01 ）incidence in different age groups of patients during hospital and within 6 months after discharge from hospital. MACE ROC curve results of two groups of patients predicted by BNP levels showed the difference was not significant （P〉0.05）. Conclusion： BNP levels and MACE in patients with different ages are different, but age does not affect the prognos- tic value of patients with ACS by BNP.