急性心肌梗死介入治疗对脑利钠肽及心室重构的影响

目的：探讨急性 ST段抬高型心肌梗死（STEMI）患者行经皮冠状动脉介入治疗（PCI）对脑利钠肽（BNP）水平及心室重构的影响。方法：151例诊断为 STEMI的患者根据其治疗方式分为3组：A组（52例，行急诊 PCI治疗），B组（49例，择期行PCI治疗），C组（50例，予以标准药物治疗）。比较各组患者治疗前后 BNP水平及左心室重构情况。结果：三组患者治疗前BNP水平比较无统计学差异（F＝0.01，P＞0.05），治疗后各组 BNP水平均显著下降，其中 A组下降较B组、C组显著（242.7±101.3）ng/L比（466.2±113.5）ng/L比（601.4±126.7）ng/L]，差异有显著性（P均＜0.01）。各组治疗前左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）比较差异均无显著性（P＞0.05）；治疗后，三组心室上述指标均显著升高（P＜0.05），其中 A、B组LVFS升高均较C组更明显（28.9±7.6）％比（27.5±7.3）％比（22.6±6.9）％]，而 A 组 LVEF 较 B 组、C 组升高（57.9±6.2）％比（53.1±6.5）％比（50.9±5.7）％]，差异有显著性（P均＜0.01）。结论：经皮冠脉介入治疗急性 ST段抬高型心肌梗死患者能有效改善心室重构，同时降低脑利钠肽水平，且急诊经皮冠脉介入治疗比择期介入治疗疗效更明显。

Influence of percutaneous coronary intervention on brain natriuretic peptide and ventricular remodeling ;in patients with acute ST elevation myocardial infarction

Objective：To explore influence of percutaneous coronary intervention （PCI）on brain natriuretic peptide （BNP）level and ventricular remodeling in patients With acute ST elevation myocardial infarction （STEMI）.Meth-ods：According to their therapeutic methods,a total of 151 patients diagnosed as STEMI Were divided into group A （n=52,received emergency PCI treatment）,group B （n=49,received selective PCI treatment）and group C （n=50,received standard medication）.BNP level and left ventricular remodeling Were compared among three groups before treatment and after treatment.Results：There Was no significant difference in BNP level among three groups before treatment （F=0.01,P〉0.05）,BNP level significantly decreased among three groups after treatment,com-pared With group B and C,there Was significant decrease in BNP level （466.2±113.5）ng/L vs.（601.4±126.7） ng/L vs.（242.7±101.3）ng/L]in group A （P〈0.01 all）.There Were no significant difference in left ventricular end-diastolic volume （LVEDV）,left ventricular end-systolic volume （LVESV）,left ventricular ejection fraction （LVEF）and left ventricular fractional shortening （LVFS）among three groups before treatment （P〉0.05 all）;af-ter treatment,there Were significant increase in above ventricular indexes in three groups （P〈0.05 all）,compared With group C,there Were significant increase in LVFS （22.6±6.9）% vs.（28.9±7.6）% vs.（27.5±7.3）%]in group A and B,compared With group B and C,there Was significant increase in LVEF （53.1±6.5）% vs.（50.9± 5.7）% vs.（57.9±6.2）%]in group A （P〈0.01 all）.Conclusion：PCI could effectively improve ventricular re-modeling and decrease BNP level in STEMI patients,and emergency PCI shoWs more significant therapeutic effects than selective PCI.