急性心肌梗死患者血浆脑利钠肽水平的变化

目的探讨急性心肌梗死（AMI）患者血浆脑利钠肽（BNP）水平变化的特点及其对AMI患者心肌梗死面积和左心室重构的预测价值。方法测定91例AMI患者（心肌梗死组）和90例健康体检者（对照组）血浆BNP水平，比较不同梗死范围和病变冠脉支数患者间BNP水平的差别。结果心肌梗死组较对照组BNP（ng／L）（155．03±113．45、71．03±37．01）和左心室舒张末径（cm）（5．11±0．51、4．56±0．43）明显增高（均P〈0．01），左心室射血分数（％）（50．84±7．98、57．09±6．29）明显降低（P〈0．01）；广泛前壁心肌梗死组较下、后壁心肌梗死组BNP、左心室舒张末径均明显增高（均P〈0．05），左心室射血分数明显降低（P〈0．05）。结论AMI患者血浆BNP明显增高，尤以广泛前壁心肌梗死者为甚，BNP能反映心肌梗死的严重程度和左心室重构。

The changes of brain natriuretic peptide in patients with myocardial infarction

Objective To observe the changes of brain natriuretic peptide(BNP)in patients with myocardial infarction,and to assess the clinical value of BNP in the patients with myocardial infarction.Methods BNP was determined in 91 patients with myocardial infarction and in 90 normal cases,and the difference was studied between the area of myocardial infarction and the number of coronary arteries stenosis.Results BNP(ng/L)(155.03 ± 113.45,71.03 ±37.01)and LVEDd(cm)(5.11 ±0.51,4.56 ±0.43)were significantly increased in patients with myocardial infarction than that in normal cases(P＜0.01),but EF(%)(50.84 ±7.98,57.09 ±6.29)was lower than that in normal cases(P＜0.01).BNP and LVEDd were also significantly higher in patients with wide-anterior myocardial infarction than that in antero-septal,inferior and posterior wall myocardial infarction,but LVEF was lower.Conclusion The BNP level was higher in patients with myocardial infarction,especially in patients with wide-anterior myocardial infarction.BNP was a reliable bio-chemical marker which can evaluate the degree and prognosis of patients with myocardial infarction.