The Predicting Value of the Level of BUN for the Long Term Mortality of the STEMI Patients_West China Medical Journal

Authors：

WANG Linling , WANG Ping , LIU Xiaokang , et al.

Department of Cardiology, the First People’s Hospital of Liangsan, Xichang Sichuan 615000, China;

Corresponding author：

Keywords：

血浆尿素氮; 肾小球滤过率; 心肌梗塞; 预后

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目的:肾功能不全在急性冠脉综合症及其它心血管疾病中通常伴随着较高的死亡率。而血浆尿素氮是反映血液动力学改变及肾脏灌注改变的非常敏感的指标。本试验研究血浆尿素氮水平的高低对于急性ST段抬高型心肌梗塞患者死亡率的预测作用。方法:研究300名患急性ST段抬高型心肌梗塞患者长程的死亡率与入院时血浆尿素氮水平及住院时血浆尿素氮水平升高之间的关系。结果:在平均随访27个月,56(185%)个患者死亡。使用生存分析对于血浆尿素氮水平升高与血浆尿素氮水平正常两组患者进行研究,用log-rank检验将两组数据进行比较,有明显统计学意义,P lt;0.001。结论:对于患急性ST段抬高型心肌梗塞患者的长期死亡率,入院时的血浆尿素氮水平是一个独立的预测因素。BUN和BUN/creatinine比值的增高也能对患急性ST段抬高型心肌梗塞患者的长期死亡率提供一定的预测信息。同时,住院期间的BUN增高对于患急性ST段抬高型心肌梗塞患者的长期死亡率也能够提供额外的预测信息。

Citation： WANG Linling,WANG Ping,LIU Xiaokang,et al.. The Predicting Value of the Level of BUN for the Long Term Mortality of the STEMI Patients. West China Medical Journal, 2009, 24(8): 2123-2125. doi: Copy

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11.	王乐丰, 刘宇.慢性肾功能不全合并急性冠脉综合征的抗栓治疗[J].临床内科杂志,2008,25(7): 446-448.
12.	MCCULLOUGH PA. Why is chronic kidney disease the “spoiler” for cardiovascular outcomes[J]? J Am Coll Cardiol, 2003,41(2):725–728.
13.	BEATTIE JN, SOMAN SS, SANDBERG KR, et al. Determinants of mortality after myocardial infarction in patients with advanced renal dysfunction[J]. Am J Kidney Dis, 2001,37(11):1191–1200.
14.	ARONSON D, MITTLEMAN MA, BURGER AJ. Elevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failure[J]. Am J Med, 2004,116:466–473.
15.	BROSIUS III FC, HOSTETTER TH, KELEPOURIS E, et al. Detection of chronic kidney disease in patients with or at increased risk of cardiovascular disease: a science advisory from the American Heart Association[J]. J Am Coll Cardiol,2002,38(5):751-762.

1. 黄庆武, 吕留彩, 王厚行,等.BXC1型脲酶电极测定血浆尿素氮的初步探讨[J].中华医学检验杂志,1990, 13(5): 258-260.
2. 王继贵,译.急性冠脉综合征病人早期危险性评价[J].实验与检验医学, 2008, 26(5): 570.
3. SHLIPAK MG, HEIDENREICH PA, NOGUCHI H, et al.Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients[J]. Ann Intern Med, 2002,137(9):555–562.
4. 钟光珍, 那开宪.ACC/AHA不稳定型心绞痛和非ST段抬高心肌梗死治疗指南(2007年修订版)解读(3)[J].中国临床医生,2008,36(11):74-75.
5. 高璐, 秦明照, 常志文.代谢综合征患者血尿酸水平与冠脉病变的关系[J].中国医刊,2008,43(11):33-35.
6. ANAVEKAR NS, MCMURRAY JJ, VELAZQUEZ EJ, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction[J]. N Engl J Med, 2004,351(6):1285–1295 .
7. 朱政斌, 张瑞岩, 沈卫峰.慢性肾病合并冠状动脉粥样硬化的他汀治疗[J].临床内科杂志,2008,25(7): 449-451.
8. FONAROW GC, ADAMS JR KF, ABRAHAM WT, et al. Risk stratification for inhospitalmortality in acutely decompensated heart failure: classification and regression tree analysis[J]. Jama,2005,293(10):572–580.
9. KIRTANE AJ, LEDER DM, WAIKAR SS,et al. Serum blood urea nitrogen as an independent marker of subsequent mortality among patients with acute coronary syndromes and normal to mildly reduced glomerular filtration rates[J]. J Am Coll Cardiol, 2005,45(2):1781–1786.
10. ALPERT JS, THYGESEN K, ANTMAN E, et al. Myocardial infarction redefined—a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction[J]. J Am Coll Cardiol,2000,36(9):959–969.
11. 王乐丰, 刘宇.慢性肾功能不全合并急性冠脉综合征的抗栓治疗[J].临床内科杂志,2008,25(7): 446-448.
12. MCCULLOUGH PA. Why is chronic kidney disease the “spoiler” for cardiovascular outcomes[J]? J Am Coll Cardiol, 2003,41(2):725–728.
13. BEATTIE JN, SOMAN SS, SANDBERG KR, et al. Determinants of mortality after myocardial infarction in patients with advanced renal dysfunction[J]. Am J Kidney Dis, 2001,37(11):1191–1200.
14. ARONSON D, MITTLEMAN MA, BURGER AJ. Elevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failure[J]. Am J Med, 2004,116:466–473.
15. BROSIUS III FC, HOSTETTER TH, KELEPOURIS E, et al. Detection of chronic kidney disease in patients with or at increased risk of cardiovascular disease: a science advisory from the American Heart Association[J]. J Am Coll Cardiol,2002,38(5):751-762.

West China Medical Journal

The Predicting Value of the Level of BUN for the Long Term Mortality of the STEMI Patients

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