B型利钠肽在急性心肌梗死患者不同治疗方式中的变化

目的:本研究旨在通过分析急性ST段抬高心肌梗死患者基础及经皮冠状动脉介入治疗(PCI)后B型利钠肽(BNP)水平,探讨PCI治疗对BNP水平的影响及BNP与近期顶后的关系.方法:入选急性ST段抬高心肌梗死患者103例,依据入院后治疗方式分为6小时内PCI组40例,6～12小时PCI组33例,药物治疗组30例.所有患者于入院即刻、发病48小时及7天时从外周静脉中留取血样测定BNP,分别比较不同时间不同治疗方式之间BNP的差别,以及BNP与1个月时心功能的关系.所有患者均无心力衰竭、陈旧性心肌梗死及肺部、肾脏疾病史.结果:①3组患者入院即刻基础BNP水平无统计学意义(P＞0.05).发病48小时、7天时6小时内PCI组BNP水平较6～12小时PCI组均明显下降,差异均有统计学意义(P＜0.05～0.01),6小时内PCI组较药物治疗组亦明显下降,差异均有统计学意义(P＜0.05～0.01);发病48小时6～12小时PCI组BNP水平与药物治疗组相比较差异无统计学意义(P＞0.05).发病7天时6～12小时PCI组BNP水平与药物治疗组比显著下降,差异有统计学意义(P＜0.05).②发病7天时的BNP水平与1个月时心功能左心室射血分数有明显相关性(r=-0.722,P＜0.001),与Tei指数呈正相关(r=0.582,P＜0.001).③随访时发生心力衰竭、心绞痛及心血管事件的患者回顾发病7天时BNP水平明显高于未发生者(P＜0.05～0.001).结论:在急性ST段抬高心肌梗死患者中,发病7天时BNP水平与近期心功能显著相关,对近期心血管事件的发生有一定预测作用,早期PCI可以显著降低发病7天时BNP水平及降低心血管事件的发生率.

The Level Change of Plasma B-type Natriuretic Peptide in Patients With Acute Myocardial Infarction Received Early Percutaneous Coronary Intervention

Objective:To evaluate prngnosis of patients with ST elevation myocardial infarction(STEMI)by examining B-type natriuretic peptide(BNP)levels after percutaneous coronary intervention(PCI). Methods:A total of 103 consecutive patients with STEMI were enrolled.They were divided into 3 groups:Group 1(received PCI within 6 hours from the onset,n=40);Group 2(received PCI within 6-12 hours from the onset,n=33);Group3(received medication,n=30).Blood samples for BNP were drawn at admission,48 hours and 7days from the...