急性心肌梗死早期血浆脑钠肽水平的变化及临床意义

目的分析急性心肌梗死早期血浆脑钠肽水平的变换情况，为临床治疗积累经验。方法选择稳定型心绞痛（SA）患者、不稳定型心绞痛（uA）患者及健康对照组各20例测定血浆BNP浓度，急性心肌梗死（AMI）患者40例于症状发作后2h、4h、6h、24h测定血浆BNP浓度。AMI患者于症状发作后6h同时测定血清肌钙蛋白含量。结果uA组BNP水平（145．07±78．15）pg／mL明显高于SA组（32．05±7．75）pg／mL，P〈0．01；AMI发病后4h、6h、24h血浆BNP水平（220．15±126．30）pg／mL、（335．83±170．41）pg／mL、（489．90±244．73）pg／mL，均明显高于uA组（145．07±78．15）pg／mL，P〈0．01，且随着症状发作时间的延长而明显增高，P〈0．01。AMI组患者症状发作6h血浆BNP水平与CTnI呈明显正相关，r=0．874，P〈0．01。结论血浆BNP可以作为AMI早期诊断的辅助指标。

The Dynamic Changes and Clinical Meaning of BNP in Serum of Patients with Early Acute Myocardial Infarction

Objective To discuss the dynamic changes and also the clinical significance of BNP in the patients with no cardiac insufficiency after the onset of AMI. Methods Serum BNP of 20 SA cases, 20 UA cases, 20 healthy cases was tested and the serum BNP of 40 AMI cases also be testde in 2h, 4h, 6h, 24h after the onset time. Determine the serum eTnI concentration of AMI patients after 6h of onset. Results BNP level of UA group（145.07±78.15）pg/mL are obviously higher than SA group （32.05±7.75 pg/mL）, P〈0.01. BNP level in 4h, 6h, 24h after AMI onset（220.15±126.30） pg/mL, （335.83±170.41）pg/mL, （489.90±244.73）pg/mL） are obviously higher than UA group（145.07±78.15）pg/mL, P〈0.01, and with the onset time prolonging, BNP level in AMI group is increasing obviously, the BNP level and cTnI are having positive relativity in 6h after the AMI onset, r=0.874 ,P〈0.01. Conclusion The serum BNP level may be another biochemistry marker to predict the prognosis of AMI patient.