【摘要】 目的 探讨B型钠尿肽(BNP)对急性冠脉综合征(ACS)危险分层的价值。方法 用酶联免疫吸附法(ELISA)检测了70例经冠脉造影证实的ACS患者(30例急性心肌梗死，40例不稳定性心绞痛)及15例非冠心病对照组的BNP的水平。随访ACS患者30天，观察终点为心肌梗死新发或再发、出现或心衰恶化和心源性猝死。结果 血清BNP(中位数，极差)在急性心肌梗死组(139pg/ml，13～980pg/ml)和不稳定性心绞痛组(90pg/ml，19～350pg/ml)明显高于非冠心病组(28pg/ml，10～80pg/ml)，P<0.05;急性心肌梗死组和不稳定性心绞痛组间无统计学差异。BNP≤80pg/ml组较BNP>80pg/ml组有更高的心肌梗死新发或再发率、心衰发生或恶化率。多因素Logistic回归分析显示BNP(OR2.328，95%CI1.597～2.876)可独立地预测ACS患者近期预后。结论 BNP对ACS患者近期预后有重要的临床价值，可作为危险分层的指标。

    Sun Lie，Hu Wenzhi，Du Xiaoyun

    Department of Cardiology，the First Affiliated Hospital of Lanzhou Medical College，Gansu730000.

    【Abstract】 Objective To explore the value of B-type natriuretic peptide(BNP)in the risk stratification in acute coronary syndrome(ACS).Methods We measured levels of serum BNP among70ACS patients verified by coronary angiography including30acute myocardial infarction(AMI)，40unstable angina pectoris(UAP)and15withˉout coronary heart disease(CHD)as control by ELISA.Patients with ACS were followed up30days.The end point was cardiac events including new or recurrent myocardial infraction(MI) ......