To Explore the Value of Plasma NT-proBNP and Hypersensitive C-reactive Protein in Evaluating the Prognosis of the Patients with Acute Coronary Syndrome
|Keywords||Acute coronary syndrome N-terminal B-type natriuretic peptide precursor Ultra- sensitivity C -reactive protein Echocardiography|
Objective: To investigate plasma the the NT-ProBNP and high-sensitivity C-reactive protein (Hs-CRP) levels vary in different types of acute coronary syndrome (ACS) patients as well as cardiac structure and function parameters, and further explore their ACS the prognosis of patients assessed value. Methods: Tongji University Oriental Hospital Department of Cardiology, May 2009-October 2010 admitted to examination for ACS patients with a total of 98 cases, 61 cases were male and 37 females, aged 38-80 years old. 33 patients divided into three groups: 98 patients with ACS with unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) of 32 patients with ST-segment elevation myocardial infarction (STEMI) patients with 33 cases. NT-proBNP, Hs-CRP, creatinine, urea nitrogen, uric acid concentrations were measured indicators (blood indicators by Tongji University Oriental Hospital clinical laboratory test) to collect the patient's blood. Produced by Philips iE33 color Doppler ultrasound to record patients following indicators, structural parameters: left atrial diameter (LAD), left ventricular end-diastolic (LVEDd), end-systolic left ventricular internal diameter (LVEDs), septal thickness (IVST), left ventricular posterior wall end-diastolic thickness (LVPWd); cardiac function parameters: stroke volume (SV), left ventricular fractional shortening rate (FS), cardiac output (CO), left ventricular ejection fraction (LVEF ). Application SPSS17.0 statistical software for statistical analysis. Groups cardiac ultrasound detection indicators differences Kruska-Wallis H rank sum test; NT-proBNP, Hs-CRP logarithmic transformation, blood indicators of differences between groups a twenty-two t test; indicators of blood and cardiac ultrasound detection The correlation between the indicators analyzed using Pearson correlation test; blood indicators of cardiac ultrasound detection indicators multivariate analysis using stepwise multiple regression analysis, the introduction of variable test level was set at 0.05, excluding variable inspection levels set at 0.1. Results: (1) between the groups blood parameters in comparison: NT-proBNP, Hs-CRP levels in the MI group (including NSTEMI and STEMI group) was significantly higher than the UA group, the difference was statistically significant (P lt; 0.05), while the no statistical difference between NSTEMI group and STEMI group (P gt; 0.05). (2) cardiac ultrasound test results among the three groups: the NSTEMI group of UA group, SV, FS, CO, LVEF significantly lower, the difference was statistically significant (P lt; 0.05); STEMI group compared with the UA group, in FS, LVEF significantly reduce, LVPWd significantly increased, the difference was statistically significant (P lt; 0.05); the STEMI group NSTEMI group, the difference was not statistically significant. (3) blood indicators of cardiac ultrasound detection results related to sex: of NT-proBNP level with SV, FS, CO, LVEF was negative related (P lt; 0.05), with the LAD, LVEDs showed a positive correlation; Hs-CRP levels and FS LVEF were negatively correlated (P lt; 0.05). Conclusions: (1) NT-proBNP and Hs-CRP levels can be used as one of the prompts indicator of the severity of illness of patients with ACS. (2) ACS patients with plasma NT-proBNP and Hs-CRP was significantly positively correlated, there may be a unique synergy between NT-proBNP and inflammatory cytokines. (3) NT-proBNP, Hs-CRP level of detection, is not only to evaluate the cardiac function of patients with ACS sensitive indicators of the level of impairment, and may judge useful indicator of myocardial ischemia, necrosis, inflammatory reaction degree of early heart of ACS patients functional decline and prognostic evaluation of an important role.