重组人脑利钠肽对PCI术后患者心肌微循环及心肌酶谱的影响

目的探讨重组人脑利钠肽对经皮冠状动脉介入(PCI)术后患者心肌微循环及心肌酶谱的影响方法2017年2月一2019年5月成都市第六人民医院院收治的90例AMI患者,随机分为观察组(n=45)和对照组(n=45)。对照组患者均接受PCI术治疗,术后服用常规药物,观察组在此基础上采用重组人脑利钠肽治疗。对比两组患者的心肌微循环、血管紧张素Ⅱ、醛固酮、心肌酶谱及心功能水平结果治疗后,两组患者左心室射血分数(left ventricular ejection fraction,LVEF)水平升高,且观察组患者LVEF水平(42.53±7.68)%]高于对照组(36.86±7.44)%,P<0.05]治疗后,两组患者血管紧张素Ⅱ、胳固S同、左室舒张末期内径(Left ventricular end-diastolic diameter,LVEDD)、左室收缩末期内径(Left ventricular end systolic diameter,LVESD)、肌酸激酶(Creatine kinase,CK)及肌酸激酶同工酶(Creatine kinase isoenzyme,CK-MB)水平均降低,且观察组患者血管紧张素Ⅱ、醛固酮、LVEDD、LVESD、CK及CK-MD水平(21.57±6.42)pg/L,(130.01±6.01)pg/L,(43.46±4.79)mm,(32.31±4.36)mm,(19.67±2.42)U/L,(13.83±3.43)U/L]低于对照组(25.93±7.90)pg/L,(133.17±7.21)pg/L,(49.07±5.11)mm,(36.65±4.10)mm,(22.43±3.04)U/L,(15.78±3.91)U/L,P<0.05]。治疗后,观察组及对照组患者心肌梗死溶栓(Thrombolysis in myocardial infarction,TIMI)血流分级无统计学差异(2.74±0.71),(2.62±0.66),P>0.05]治乃后,观察组计帧值(Myocardial frame count,CTFC)低于对照组(23.45±4.29),(32.52±4.73),P<0.05]。结论重组人脑利钠肽可有效改善PCI术后患者心肌微循环,降低心肌损伤,进而提高心功能,具有临床推广价值。

Effects on myocardial microcirculation,vascular endothelial function and myocardial enzyme profile in patients after PCI by using recombinant human brain natriuretic peptide

Objective To explore ihe effect on myocardial microcirculation,vascular endotlielial function and myocardial enzyme profile in patients after percutaneous coronary intervention(PCI)by using recombinant human brain natriuretic peptide.Methods 90 patients with AMI admitted to Chengdu sixth peopled hospital between February 2017 and May 2019 were randomly divided into the observation group(45 cases)and the control group(45 cases).All patients in the control group received PCI and conventional drugs after surgery,and the observation group was treated with recombinant human brain natriuretic peptide on this basis.The microcirculation of myocardium,angiotensin Ⅱ,aldosterone,myocardial enzyme profile and cardiac function were compared between the two groups.Results After treatment,the level of left ventricular ejection fraction(LVEF)in the two groups increased,anti the level of LVEF in the observation group(42.53±7.68)%]was higher than that in the control group(36.86±7.44)%,P<0.05].After treatment,the levels of angiotensin D,aldosterone,left ventricular end-diastolic diameter(LVEDD),creatine kinase(CK),left ventricular end systolic diameter(LVESD)and creatine kinase isoenzyme(CK-MB)in both groups reduced,and the levels of angiotensin Ⅱ,aldosterone,LVEDD,LVESD,CK and CK-MB in the observation group(21.57±6.42)pg/L,(130.01±6.01)pg/L,(43.46±4.79)mm,(32.31±4.36)mm,(19.67±2.42)U/L,(13.83±3.43)U/L]were lower than those in the control group(25.93±7.90)pg/L,(133.17±7.21)pg/L,(49.07±5.11)mm,(36.65±4.10)mm,(22.43±3.04)U/L,(15.78±3.91)U/L,P<0.05].After treatment,there was no statistically significant difference in blood flow grading of thrombolysis in myocardial infarction(TIMI)between the two groups(2.74±0.71),(2.62±0.66),P>0.05],and the corrected thrombolysis in myocardial frame count(CTFC)of the observation group was lower than that of the control group(23.45±4.29),(32.52±4.73),P<0.05].Conclusion Recombinant human brain natriuretic,peptide can effectively improve niyocardial microcirculation,reduce myocardial injury,and improve cardiac function of patients after PCI,which is worthy for clinical promotion.