摘要
目的研究直接PCI患者脑钠肽(BNP)与18F-FDG单光子发射型断层扫描(SPECT)心肌代谢显像所测心肌活力之间的相关性,分析BNP与18F-FDG心肌代谢显像对于直接PCI患者预后的预测作用。方法 58例连续选入的接受直接PCI植入支架的急性ST段抬高型心肌梗死患者,于术后第7天进行18 F-FDG单光子发射型断层扫描静态心肌代谢显像检测心肌活力以及术后第1天静脉血BNP测定。所有患者随访1年,记录主要不良心脏事件(MACE)发生情况,分析MACE和静息代谢显像所测心肌活力以及BNP之间的相关性。结果 58例患者中有7例(12.06%)患者发生主要不良心血管事件。患者术后第1天的BNP与代谢显像总积分呈正相关,相关系数r为0.745(P=0.000)。MACE与术后第1天的BNP呈显著正相关(r=0.809,P=0.000),与术后第7天的代谢显像总积分呈显著正相关(r=0.892,P=0.000)。BNP与代谢显像总积分是MACE的独立预测因子(P=0.000或P=0.003),其拐点分别为282.65ng/L和33。结论对于接受直接PCI植入支架的急性ST段抬高型心肌梗死患者,术后第1天的BNP与术后第7天的心肌代谢显像总积分可有效预测入院后1年内的MACE事件发生情况。
Objective To investigate the correlation between results of 18F-FDG myocardial metabolic imaging and BNP,and evaluate their predictive value on prognosis in patients received primary PCI.Methods 58 consecutive patients underwent primary PCI were selected for determining summed metabolic score with 18 F-FDG SPECT myocardial metabolic imaging and serum BNP level at 7th day and 1th day after the stent implantation.All cases were followed up for 1 year to record major adverse clinical events （MACE）.Then the correlations of summed metabolic score and BNP to MACE were analyzed.Results MACE occurred on 7 patients of the 58 cases （12.06％） during the 1-year follow-up period.Summed metabolic score and BNP after the stent implantation were positively correlated,of which the correlation coefficient were 0.745 （P=0.000）.MACE had a significantly positive correlation with summed metabolic score （r=0.892,P =0.000） and BNP （r=0.809,P=0.000） 7 days after the procedure.Summed metabolic score and BNP at the 7th day after PCI were all independent predictors to MACE in patients underwent primary PC1 during the first year after operation （P=0.000,P=0.003）.According to ROC,inflection point of summed metabolic score and BNP at the 7th day and 1th day after PCI were 282.65ng/L and 33,respectively.Conclusion For patients received primary PCI,summed metabolic score and serum BNP level after procedure are effective in predicting MACE during the first year after operation.
出处
《西部医学》
2013年第11期1669-1671,共3页
Medical Journal of West China
基金
徐州市科技局社会发展科技计划项目(XZZD113)
关键词
急诊PCI
心肌代谢显像
脑钠肽
Primary PCI
Myocardial metabolic imaging
BNP
Prognosis
