急性心肌梗死患者脑钠尿肽浓度与冠脉病变程度及预后的关系

目的探讨脑钠尿肽（BNP）浓度与急性心肌梗死冠状动脉病变程度及预后的关系。方法根据心肌梗死初期脑钠尿肽浓度将132例急性心肌梗死分为两组,A组58例：BNP浓度〉100ng/L;B组74例：BNP浓度≤100ng/L。将两组冠脉造影结果及预后进行比较分析。结果 A组多支血管病变48例（83%）、梗死相关血管近端病变42例（72%）、梗死相关血管为前降支37例（64%）、心力衰竭24例（41%）、严重心律失常16例（28%）、梗死后心绞痛14例（24%）,左室射血分数（43±12）%,病死率14%。B组多支血管病变39例（53%）、梗死相关血管近端病变16例（22%）、梗死相关血管为前降支19例（26%）、心力衰竭9例（12%）、严重心律失常6例（8%）、梗死后心绞痛5例（7%）,左室射血分数（52±9）%,病死率3%。两组分项比较差异有统计学意义。结论脑钠尿肽浓度升高的急性心肌梗死多支血管病变,梗死相关血管多为前降支,梗死相关血管多为近端病变,预后不好。

Brain natriuretic peptide is associated with severity of coronary artery disease and prognosis in acute myocardial infarction

Objective To explore the relation between the severity of coronary artery disease,prognosis and brain natriuretic peptide（BNP）in acute myocardial infarction（AMI）.132 patients with AMI were divided into two groups（group A：BNP100ng/L,n=58;group B：BNP≤100ng/L,n=74）based on BNP concentrations.Both group′s data were compared with coronary angiographic findings and prognosis.In group A,there were 31 multi-vessel disease（53%）.42 proximal lesions of infarction related artery（72%）,37 cases′ infarction related artery in LAD（64%）,24 cases of heart failure（41%）,16 cases of serious cardiac arrhythmias（28%）,14 cases of post-infarction angina pectoris（24%）,and left ventricular ejection fraction was（43±12）%,and the mortality was 14%.In group B,there were 13 multi-vessel disease（18%）,16 proximal lesions of infarction related artery（22%）,19 cases′ infarction related artery in LAD（26%）,9 cases of heart failure（12%）,6 cases of serious cardiac arrhythmias（8%）,5 cases of post-infarction angina pectoris（7%）,and left ventricular ejection fraction was（52±9）%,and the mortality was 3%.There were significant difference in the above index between group A and B.Multivessel disease,infarction related artery in LAD,proximal lesion,and poor prognosis are found in patients with AMI with high BNP.