急性心肌梗死患者血浆脑尿钠肽与心功能的相关性

目的:探讨急性心肌梗死(AMI)患者血浆脑钠尿肽(BNP)与左心室射血分数(LVEF)、左心室舒张末容积(LVEDV)、Killip分级及心肌梗死部位的关系,评价BNP对AMI患者心功能和危险分层的预测价值。方法:检测120例AMI患者和120例对照组血浆BNP水平,同时行心脏彩色多普勒检测LVEF、LVEDV,比较AMI组与对照组以及不同LVEF、Killip分级和不同梗死部位亚组间的血浆BNP水平差异。结果:与对照组相比,AMI组BNP和LVEDV显著升高,LVEF显著降低(均P<0.01)。与LVEF>50%组比较,LVEF<40%组BNP、LVEDV显著升高(P<0.05);与Killip I、II级比较,Killip III、IV级组BNP显著升高(P<0.05),Killip IV级组LVEDV显著增大(P<0.05)。与下壁心肌梗死患者相比,下后壁、前壁梗死患者BNP显著升高(P<0.05)。BNP与Killip分级成正相关(r=0.97,P<0.05),与LVEF成负相关(r=-0.33,P<0.05)。结论:AMI患者血浆BNP显著增高,尤以LVEF<40%、Killip IV级、前壁心肌梗死者为甚。

Relationship between plasma levels of brain natriuretic peptide and cardiac function in patients with acute myocardial infarction

AIM: To explore the relationship between plasma brain natriuretic peptide(BNP) and left ventricular ejection fraction(LVEF),left ventricular diastolic volume(LVEDV),and Killip classification and to evaluate the predictive value of BNP in patients with acute myocardial infarction(AMI).METHODS: A total of 120 AMI patients and 120 control subjects were investigated by measuring plasma BNP levels using MEIA.LVEF and LVEDV were assessed using echocardiography.RESULTS: Plasma BNP levels and LVEDV in AMI groups were significantly higher than those in control group;however,LVEF was significantly lower than that in control group(P<0.01).Plasma BNP levels and LVEDV in LVEF <40% group were higher than those in LVEF >50% group(P<0.05).BNP levels in Killip III and IV groups were also significantly higher than those in Killip I and II groups(P<0.05).Compared with those in patients with inferior myocardial infarction,BNP levels were significantly higher in patients with anterior myocardial infarction and inferior-posterior myocardial infarction(P<0.05).There was a positive correlation between BNP levels and Killip classification(r=0.97,P=0.029),but a negative correlation between BNP levels and LVEF(r=-0.33,P=0.0036).CONCLUSION: Plasma BNP levels are significantly increased in AMI patients,especially in patients with LVEF <40%,Killip IV or extensive anterior myocardial infarction.BNP indicates the severity of myocardial infarction,which may be an important predictor for left ventricular dysfunction.