早期再灌注治疗对急性心肌梗死患者脑钠肽水平和近期左心室重构的影响  

The Effect of Early Reperfusion Therapy on Plasma Brain Natriuretic Peptide and Left Ventricular Remodeling in Patients with Acute Myocardial Infarction

作　　者：龚浩[1] 胡威[1] 李洁芳[1] 李莉[1] 

机构地区：[1]湖南省长沙市第四医院,湖南长沙410006

出　　处：《医学临床研究》2006年第7期1073-1074,1077,共3页Journal of Clinical Research

摘　　要：【目的】探讨早期再灌注治疗对急性心肌梗死（AMI）患者脑钠肽（BNP）水平和近期左心室重构及左心功能的影响。【方法】选择50例首发AMI患者，胸痛发作12h内成功再灌注者为试验组（26例），再灌注失败或未进行再灌注者为对照组（24例），在发病后3～4d采集静脉血测BNP的浓度。心肌梗死1周后和12周后行超声心动图检查，测定左心室射血分数（LVEF）、左心室容积参数。【结果】与对照组相比，急性期内试验组的BNP浓度明显降低，12周后左室收缩末容积指数（LVESVI）明显降低、LVEF明显升高。BNP与心肌梗死1周后和12周后LVESVI呈正相关。【结论】早期成功再灌注能降低AMI患者BNP水平，减缓近期左室重构，改善左心功能；BNP具有一定的预测价值。[Objective]To investigate the effect of early reperfusion therapy on plasma brain natriuretic peptide, left ventricular remodeling and left ventricular function in patients with acute myocardial infarction （AMI）.[Methods]The study group included 50 patients with AMI, 26 patients underwent successful early reperfusion in 12 hours after chest pain attack as the test group ,24 patients underwent non-successful or rejected reperfusion as the control group . Plasma samples were obtained at 3- 4 days after AMI for brain natriuretic peptide （BNP） measured with Triage BNP test. Echocardiography was performed in 50 patients with AMI at 1,12 weeks after AMI . Left ventricular end systolic volume （LVESV） and diastolic volume （LVEDV ）,and left ventricular ejection fraction （LVEF） were detected. [Results]Compared with controls ,Plasma BNP levels were significantly lower in acute phase. Compared with controls, 12 weeks after AMI,LVESV was significantly lower and LVEF significantly higher in the test group. Plasma BNP was correlated with LVESV at 1 week （r=-0.46, P 〈0. 01）,and 12 weeks （r=0.61, P 〈0. 01）after AMI. [Conclusion]Early successful reperfusion therapy can decrease BNP level in patients with AMI ,prevent left ventricular remodeling and improve left ventricular function.

关 键 词：心肌梗塞 急性病 利钠肽 脑/分析 再灌注 心室功能 左 

分 类 号：R561.4[医药卫生—呼吸系统]