脑钠素在评价冠心病介入治疗改善心功能中的价值  

Plasma level of natriuretic peptide to evaluate coronary interventional treatment's effect on heart function improvement.

作　　者：张悟棠[1] 王凤芝[1] 巩书文[1] 邢雪琴[1] 李保[2] 王敬平[2] 孔咏梅[2] 李卫菊[3] 

机构地区：[1]山西医科大学第二医院心内科,030001 [2]山西省心血管疾病医院心内科 [3]山西省人民医院心内科

出　　处：《中国药物与临床》2005年第11期831-833,共3页Chinese Remedies & Clinics

摘　　要：目的判定脑钠素(BNP)在评价冠心病(CHD)患者行经皮冠状动脉介入治疗(PCI)改善心功能中的价值。方法测定连续43例成功接受PCI的CHD患者术前及术后第4天晨血浆BNP及超声心动图(UCG)室壁运动情况、左室射血分数(LVEF)、短轴缩短分数(FS)、舒张早期充盈峰的最大速度(E峰)、舒张晚期充盈峰的最大速度(A峰)及E/A。结果43例冠心病患者总体PCI术前及术后第4天UCG的变化不明显(P>0.05);而PCI术后第4天BNP较术前显著下降(P<0.05),特别是心肌梗死组(尤其是前壁心梗组)、室壁运动异常组、左室扩大组、心功能不全组、三支病变组、冠状动脉严重狭窄组、罪犯血管再通组术后BNP较术前BNP下降更明显(P<0.05)。结论BNP评价PCI的近期疗效优于UCG,可作为评价PCI术改善心功能近期疗效的敏感指标。Objective This study is aimed at investigating the brain natriuretic peptide（BNP）＇s role in evaluating the effect of percutaneous coronary intervention（PCI） for improving the ventricular function of patients with coronary heart disease（CHD）. Methods The plasma BNP levels and indexes of echocardiogram including ventricular movement by ultrasonic cardiography（UCG）, left ventricular eject fraction（LVEF）, left ventricular shortening fraction（FS）, E wave, A wave ang E/A were measured before PCI and four days after PCI in 43 consecutive patients, and the results before and after PCI were compared. Results There were no statistical differences between the changes of echocardiogram before and after PCI（P〉0.05）. The BNP concentration after PCI in all 43 patients was significantly lowered compared to that before PCI（P〈0.05）. This change was especially remarkable in patients with myocardial infarction（particularly in patients with anterior myocardial infarction）, abnormal ventricular movement, left ventricular enlargement, cardiac dysfunction, three branches disease, the severe coronary stenosis and the restored blood flow of the culprit blood vessel. Conclusion BNP is a sensitive and specific index for evaluating the earlier curative effect of PCI in improving the ventricular function for CHD patients.

关 键 词：超声心动描记术 多普勒 彩色 脑钠素 心功能 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]