氨基末端脑钠肽前体在急性ST段抬高型心肌梗死急诊PCI术后患者中的临床意义

目的评价急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后血浆氨基末端脑钠肽前体(NT-proBNP)水平的临床意义。方法选择207例发病24 h之内进行急诊PCI的STEMI患者,采用荧光免疫抗原抗体结合方法测定术后入院即时血浆NT-proBNP水平,收集年龄、左室射血分数(LVEF)、入院时心功能(killip分级)、发病至梗死相关血管开通时间等临床资料,并根据相应程度或等级分组,对比各组间NT-proBNP水平的差异。结果 NT-proBNP水平与年龄呈正相关(r=0.39,P=0.000),与LVEF呈负相关(r=-0.29,P=0.000);入院时killip分级Ⅲ～Ⅳ级组和Ⅱ级组NT-proBNP水平高于I级组(P均<0.01);随着STEMI患者梗死相关血管开通时间的延迟,NT-proBNP水平依次增高(P均<0.01)。结论 STEMI患者PCI术后血浆NT-proBNP水平与年龄、LVEF、killip分级、发病至梗死相关血管开通时间相关。

Clinical significance of N-terminal brain natriuretic peptide in acute ST-segment elevation myocardial infarction patients of having reveived emergency percutaneous coronary intervention

Objective To evaluate the clinical significance of N-terminal brain natriuretic peptide(NT-proBNP) in acute ST-segment elevation myocardial infarction(STEMI) patients of having reveived emergency percutaneous coronary intervention(PCI).Methods A total of 207 patients had diagnosed as acute STEMI and had reveived emergency PCI within 24 hours since the symptoms occurred were included.We detected the plasma NT-proBNP level immediately after emergency PCI with immunofluorescence technic,collected clinical data during hospitalization,including admission age,Killip classification of cardiac function,left ventricular ejection fraction(LVEF) in cardiac ultrasonography,duration from onset to patency of diseased vessels,and then divided the patients into several subgroups according these data and analyzed the difference of NT-proBNP among the subgroups.Results Plasma NT-proBNP level had a positive correlation with age(r=0.39,P=0.000),and negative correlation with LVEF(r=-0.29,P=0.000);Plasma NT-proBNP level in Killip Ⅲ-Ⅳ and Ⅱ subgroup were higher than Killip Ⅰ subgroup(P<0.01);Plasma NT-proBNP level increased as the patency time of infarct related artery prolonged(P<0.01).Conclusion Plasma NT-proBNP levels in acute STEMI patients who received emergency PCI are related to patients’ age,LVEF,Killip classfication of cardiac function,and the patent time of criminal vessels.