美托洛尔注射液早期治疗非ST段抬高急性心肌梗死患者血清氨基端脑钠肽前体水平研究

目的:观察美托洛尔注射液早期治疗非ST段抬高急性心肌梗死患者血清氨基端脑钠肽前体(NT-ProBNP)水平变化.方法:将69例非ST段抬高急性心肌梗死患者(KiUip分级Ⅰ～Ⅱ级)随机分成两组,治疗组34例为症状出现24 h内予静脉注射美托洛尔,对照组35例为常规治疗.两组均在入选6 h内、第7天和第28天检测血清NT-ProBNP浓度以及监测第1天、第28天左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、室上性和室性心律失常计数.结果:血清NT-ProBNP浓度变化:治疗组第7天、第28天血清NT-ProBNP浓度分别为(155.43±30.56)pg/ml、(105.43±30.56)pg/ml与对照组第7天、第28天(289.9±42.3)pg/ml、(209.9±42.3)pg/nd比较明显下降,差异有统计学意义(P＜0.05);且治疗组第7天血清NT-ProBNP浓度与最初6 h血清NT-ProBNP浓度(320.2±50.5)pg/ml相比也明显下降,差异有统计学意义(P＜0.05).69例患者28天内死亡4例患者与非死亡65例患者平均血清NT-ProBNP水平分别为[(620.8±160.5)pg/ml、(187.8±89.6)pg/ml,两者比较差异有统计学意义(P＜0.05).心脏超声变化:治疗组第1天和第28天的前后差值与对照组第1天和第28天的前后差值比较,左心室舒张末期内径、左心室收缩末期内径显著减少,差异均有统计学意义(P＜0.05).动态心电图监护:治疗组第1天和第28天的前后差值与对照组第1天和第28天的前后差值比较,室上性心律失常计数、室性心律失常计数显著升高,差异均有统计学意义(P＜0.05).结论:非ST段抬高急性心肌梗死患者早期应用美托洛尔注射液治疗是安全的,并能显著降低血清NT-ProBNP水平,降低心律失常发生,改善心室重塑.死亡患者血清NT-ProBNP浓度显著升高.

Clinical Investigation on Plasma Concentration of NT-ProBNP for Metoprolol Injection in Patients With Non-ST-Elevation Acute Myocardial Infarction

Objective:To investigate plasma concenrtration of NT-ProBNP for metoprolol injection in patients with non-ST-elevation acute myocardial infarction(AMI).Methods: A total of 69 patients with non-ST-elevation AMI were randomly divided into two groups.Treatment group: n=34,the patients were treated with metoprolol injection within 24 hours of symptoms appeared;Control group: n=35,the patients were treated with routine medication.Plasma NT-ProBNP concentrations were measured in both groups at 6 hours,7 days and ...