B型钠尿肽在急性前壁心肌梗死中的临床意义

目的研究急性心肌梗死后不同时间点B型钠尿肽对急性前壁心肌梗死危险分层的临床价值。方法分别检测入选的急性前壁心肌梗死入院即刻,心肌梗死后3天、7天外周静脉血B型钠尿肽(BNP)。检测入选患者入院次日晨检测hsCRP。观察入选患者的TNT和CK-MB的峰值,以及心电图的系列变化。结果①第3天和第7天的BNP显著高于入院即刻的BNP。②BNP与hsCRP无相关性。③第7天的BNP与TNT的峰值呈正相关。④住院期间ST段回到等电位性的患者各时间点BNP显著低于ST段持续抬高的患者。⑤行急诊再灌注治疗的患者中,ST段迅速回落的患者第3天和第7天的BNP显著低于ST段回复不良的患者。结论急性前壁心肌梗死患者发病第7天的BNP与预后相关。

Change of B-type natriuretic peptide level in the patients with acute antetior wall myocardial infarction clinical significance

Objective To reveal the inherent correlation between plasma BNP level of acute anterior wall myocardial infarction patient and severity and prognosis.Methods The 92 cases of acute anterior wall myocardial infarction patients were selected.All the patients were monitored with regular ECG.Laboratory examinations,such as plasma BNP,creatine kinase MB,cardiac troponin I,high sensitive C reaction protein(hsCRP).Results (1)The level of third day and seventh day plasma BNP are obviously higher than the level of immediate plasma BNP.(2)There is no relation between BNP and hsCRP.(3)The level of seventh day plasma BNP is positive correlation with peak value of TNT.(4)BNP is obviously higher in patients w ith ST segment persistent elevation after myocardial infarction than that with ST segenent recovery.(5)The level of third day and seventh day plasma BNP of persistent ST-segment elevation after reperfusion therapy are obviously higher than that of rapid resolution of ST-segment.Conclusion The seventh day BNP after acute anterior myocardial infarction is correlation with prognosis.