康复治疗对急性心肌梗塞患者血浆脑钠肽水平的影响

目的:观察早期康复治疗对急性心肌梗塞(AMI)患者左室收缩功能及血浆脑钠肽(BNP)水平变化的影响。方法:以超声心动图检测80例AMI患者以及20例健康对照者的左室舒张末内径(LVEDd)、左室射血分数(LVEF)及左室短轴缩短率(LVFS),应用酶联免疫吸附法(ELISA)测定两组脑钠肽(BNP)的浓度;AMI患者被随机分为传统治疗组(38例)和早期康复组(42例),3周和3月时再测定上述指标。结果:AMI患者在治疗后3周LVEDd、LVEF及LVFS与治疗前比较均无统计学差异(P>0.05),3个月时的上述指标与治疗前比较改善显著(P<0.01),但早期康复治疗组LVEF水平较传统治疗组升高更明显(P<0.05)。AMI患者在梗塞后24h血浆BNP水平均高于正常对照组,治疗3周和3月时血浆BNP水平均明显下降(P<0.01),但早期康复组较传统治疗组下降更明显(P<0.05)。两组患者血浆BNP水平与LVEF呈负相关(P<0.01)。结论:早期康复治疗可以改善AMI患者心功能和降低血浆BNP水平;AMI患者血浆BNP水平的改变早于心脏结构的变化,可作为观察AMI病情的一个灵敏指标。

Influence of early exercise rehabilitation on plasma level of brain natriuretic paptide in patient with acute myocardial in farction

Objective:To observe the change of early exercise rehabilitation on plasma level of brain natriuretic peptide(BNP) in patient with acute myocardial infarction(AMI).Methods:The AMI group(80 patients) and healthy controls group(20 cases) were examined by echocardiography and their plasma BNP concentrations were measured by enzyme linked immunosorbent assay(ELISA).The AMI group was further subdivided into conventional treat group and early exercise rehabilitation group.The parameters were re-checked three week and three months later.Results:The constructive and functional parameter(LVEF) improved significantly only after three month treatment,the plasma BNP level decreased significantly after 3-week or 3-month treatment(P<0.01).The decreased level of these parameters were greater in early exercise rehabilitation group than those in conventional treament group(P<0.05).The plasma BNP in myocardial infarction patients were apparently higher than that of healthy subjects(P<0.01) and negatively correlated with LVEF(r=-0.49,P<0.01).Conclusion:The early exercise rehabilitation may improve cardiac function and decrease the level of plasma BNP.The changes of BNP level develop earlier than those of constructive and functional parameters and can be used as a sensitive index for dynamic observe acute myocardial infarction.