脑钠肽对急性心肌梗死患者冠状动脉支架置入术后心室重塑的预测价值  

The value of brain natriuretic peptide on ventricular remodeling in patients with acutemyocardial infarction following successful coronary stent implantation

作　　者：李潞[1] 赵红丽[2] 

机构地区：[1]沈阳医学院附属第二医院心内科,沈阳110002 [2]沈阳医学院沈洲医院心内科

出　　处：《临床心血管病杂志》2005年第11期654-656,共3页Journal of Clinical Cardiology

摘　　要：目的:观察急性心肌梗死(AMI)患者行冠状动脉支架置入术前后脑钠肽(BNP)水平的变化以及BNP对术后远期心室重塑的预测价值评价.方法:入选AMI住院治疗的患者32例作为试验组,在诊断为AMI后2～4周时行冠状动脉支架置入术,另入选同期AMI未行介入治疗的患者28例作为对照组.所有入选患者均在入院时、介入术后72 h检测BNP,采用酶联免疫吸附法分析;并于入院时,介入术后72 h以及6 个月时行超声心动图检查,计算左室重量指数(LVMI)和LVMI变化值(Δ1LVMI、Δ2 LVMI).结果:2组患者基线特征差异无统计学意义(P＞0.05).入院时BNP及LVMI 2组间相似(P＞0.05);介入术后72 h试验组BNP水平低于对照组(P＜0.05),且较入院时降低(P＜0.05),而LVMI 2组间差异无统计学意义(P＞0.05);介入术后6 个月试验组LVMI,Δ1LVMI和Δ2 LVMI均较对照组明显减低(P＜0.05);对照组LVMI较入院时升高.相关分析表明介入术后72 h BNP水平与Δ2LVMI呈正相关(r=0.56, P＜0.01).结论:AMI患者行冠状动脉支架置入术治疗可使血浆BNP水平下降,术后BNP水平与LVMI的变化呈正相关,即BNP对远期心室重塑有一定的预测价值.Objective：The purpose of this study was to investigate the value of brain natriuretic peptide （BNP） on ventricular remodeling in patients with acute myocardial infarction（AMI） following successful coronary stent implantation. Method：A total of 32 patients with AMI（trial group） were treated for successful coronary stent implantation within 2-4 weeks after diagnosed AMI, and 28 patients with AMI（control group） in same time. BNP was analyzed with ELISA at baseline and 72-hour after stent in all patients. Doppler echocardiographic examination was performed at baseline, 72- hour after stent and 6 months. Left ventricular mass index （LVMI） and LVMI changes（△1 LVMI, △2 LVMI） were calculated. Result：There were no difference at baseline characteristics in two groups. The levels of BNP and LVMI of two groups were similar at baseline （ P 〉0.05）, The levels of BNP 72- hour after stent in trial group was significantly lower than control group（ P 〈0.05）and baseline; but LVMI was similar in two groups at that time（ P 〉0.05）. At 6 months after stent , LVMI, △1LVMI and △2LVMI in trial group was significantly lower than control group（ P 〈0.05）, LVMI in control group was significantly higher than baseline（ P 〈0.05）. The levels of BNP 72- hour after stent was positively correlated with △2LVMI （ r =0.56, P 〈0.01）. Conclusion：The levels of BNP in patients with AMI following successful coronary stent implantation are decreased, and positively correlated with LVMI changes.

关 键 词：心肌梗死 脑钠肽 支架 肥大 左心室 

分 类 号：R542.2[医药卫生—心血管疾病]