择期经皮冠状动脉成形术对急性心肌梗死患者氨基末端脑钠肽前体及预后的影响

目的研究急性心肌梗死（acute myocardial infarction,AMI）患者接受择期经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）后血浆氨基末端脑利钠肽前体（N-TerminalPro-Brainnatriureticpeptide,NT-proBNP）水平变化及其与心功能等愈后的关系。方法入选2009年10月～2010年10月,发病后7d接受择期PCI治疗的ST段抬高AMI患者42例（A组）及未行PCI术患者34例（B组）;使用电化学发光测量不同时间NT-proBNP水平,同时行心脏彩超评价心功能;记录两组患者住院期间及半年时动态心电图结果。结果择期PCI治疗组NT-proBNP水平较未行PCI治疗组明显下降;两组患者在治疗后第45天、半年后的超声心动图比较心功能差异有统计学意义（P〈0.05）,而新发频发多源室性期前收缩发生率差异不明显。结论 AMI患者择期PCI后NT-proBNP水平有显著下降趋势,且NT-proBNP水平可以作为患者心功能预测因子。

The effects of elective percutaneous coronary intervention on level of N-Terminal Pro-Brain natriuretic peptide and prognosis in patients with acute myocardial infarction

Objective To investigate the effects of elective percutaneous coronary intervention (PCI) on level of N-Terminal Pro-Brain natriuretic peptide (NT-proBNP) and prognosis in patients with acute myocardial infarction (AMI). Methods Seventy six patients with acute myocardial infarction were divided into group A for selective percutaneous coronary intervention treatment (n = 42) and group B for conventional treatment (n = 34). The plasma N-Terminal Pro-Brain natriuretic peptide was measured by electrochemiluminescenc, ultrasound electrocardiogram examinations and holter were carried out at different time after MI (myocardial infarction) in these patients. Results N-Terminal Pro-Brain natriuretic peptide level of patients after selective PCI was significantly lower than conventional treatment group. The results of ultrasound electrocardiogram at the 45th day and 6th month and Holter were compared among two groups: the cardiac function of patients had significant difference between two groups (P < 0.05); While it didn’t have significant difference in ultrasound electrocardiogram at the 12th-15th day and the incidence of the frequent multifocal premature ventricular beats after half year. Conclusion N-Terminal Pro-Brain natriuretic peptide level in patients with acute myocardial infarction further decline after elective percutaneous coronary intervention, and may be used as the predictor of cardiac function and ventricular remodeling of patients.