论文摘要
背景和目的:急性冠状动脉综合征（acute coronary syndrome,ACS）是由于冠状动脉粥样斑块破裂或溃烂,继发血栓形成引起冠脉血流完全中断或极度降低的病理生理改变所导致的综合征,主要包括不稳定性心绞痛（unstable angina pectoris,UAP）、ST段抬高心肌梗死（ST segment elevation myocardial infarction,STEMI）和非ST段抬高心肌梗死（non-ST segment elevation myocardial infarction,NSTEMI）,约占冠心病人的30%～40%。晚近研究表明ACS的发病率逐年升高。第21届北美心脏起搏与电生理大会公布,目前心源性猝死的病例中,冠心病占80%;在冠心病猝死中,ACS占20%,是最常见的病因,其发生率甚至大于心律失常。循证医学证实,对ACS患者早期进行危险分层,给予高危患者积极的抗血小板、抗凝及早期血运重建治疗,可明显提高花费-受益比,改善ACS患者的预后。传统对ACS患者进行危险分层多根据病史、物理检查、心电图（ECG）、C反应蛋白（Creactive protein,CRP）及心脏标记物[如肌钙蛋白I（cardiac troponin I,cTn I）;肌钙蛋白T（cardiac troponin T,cTn T）;肌酸激酶同工酶CK—MB]等。理想的预后评价指标应具有准确、可快速检测和在ACS症状发作后即呈阳性改变等特点。近年来,尽管联合应用上述指标对ACS患者进行危险分层,但准确性仍然相对较差。因此,寻找理想的ACS预后评价指标是临床亟待解决的问题。脑钠肽（B-type/brain natriuretic peptide,BNP）是心脏分泌的利钠肽家族的一员,因其首先在猪脑中发现,故名脑钠肽。利钠肽家族主要包括心钠肽（atrial natriuretic peptide,ANP）、BNP、C型利钠肽（C-type natriuretic peptide,CNP）。心钠肽主要由心房肌细胞分泌,BNP主要由心室肌细胞分泌,C型
论文目录
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标签：脑钠肽论文; 急性冠状动脉综合征论文; 预后论文;