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作 者:刘洪梅[1] 王林[1] 陈康寅[1] 李永健[1] 陈元禄[1] 周丽娟[1] 蔡金荣[1] 郑成环[1] 黄体钢[1]
机构地区:[1]天津医科大学第二医院心脏病学研究所,天津300211
出 处:《中国慢性病预防与控制》2006年第4期254-256,共3页Chinese Journal of Prevention and Control of Chronic Diseases
基 金:天津市科委重点资助项目(033111311)
摘 要:目的比较N末端脑钠素原(NT-ProBNP)与QRS积分对急性心肌梗死(AMI)患者近期心功能判定价值。方法应用酶联免疫法测定49例患者AMI后5~7d血浆NT-ProBNP水平,同期应用12导联-心电图QRS积分评价梗死范围。随访AMI后第7d、1个月、3个月时超声心动图。结果AMI患者NT-ProBNP较正常对照组升高(P<0.01);前壁组和下壁+正后壁(+右室)组NT-ProBNP均高于下壁组(P<0.05),前壁组与下壁+正后壁(+右室)组之间差异无统计学意义。前壁组QRS积分高于下壁组和下壁+正后壁(+右室)组,差异有统计学意义(P<0.05);下壁组与下壁+正后壁(+右室)组之间差异无统计学意义(P>0.05)。下壁AMI心功能2级者血浆NT-ProBNP高于1级者,而两者QRS积分差异无统计学意义。AMI后5~7d的NT-ProBNP和QRS积分与心梗后第7d、1个月、3个月时左室射血分数(LVEF)、室壁运动积分(WMS)相关。结论血浆NT-ProBNP及QRS积分与AMI范围密切相关,是反映心室重构的较敏感指标;与QRS积分相比,血浆NT-ProBNP还可反映心功能状态,故更为优越。Objective To compare the predictive value of NT-ProBNP and QRS scoring in AMI. Methods In the 5 th-7 th day after AMI, plasma NT-ProBNP was determined in 49 AMI cases with enzyme immunoassay. At the same time, their electrocardiogram QRS scoring was counted according to QRS scoring system. In the 7 th day, the 1st month and the 3 rd months after AMI, the indexes of echocardiogram were measured. Results NT-ProBNP content was significantly higher in the control group than that in the normal group (P〈0.01), also significantly higher in the anterior AMI group and the inferior + posterior (+right) AMI group than that in the inferior AMI group (P〈0.05), but there was no significant difference between the former two groups. Anterior group's QRS score was significantly higher than that of inferior group and inferior + posterior (+right) group. There was no significant difference between the latter two groups. Among the cases with inferior AMI, NT-ProBNP was significantly higher in cases with the grade Ⅱ cardiac function (killips) than in the grade Ⅰ, but QRS score had no significant difference between these two groups. NT-ProBNP content and QRS score of the 5 th-7 th day after AMI was significantly correlated with left ventricular ejection fraction (LVEF) and wall motion scoring (WMS) of the 7th day, the 1st month and the 3 rd month after AMI (P〈0.05). Conclusion NT-ProBNP and QRS scoring correlated with infarction size and ventricular remodeling. NT-ProBNP can also reflect cardiac function, so it is superior to QRS scoring in predicting cardiac function of AMI patients.
关 键 词:急性心肌梗死 N末端脑钠素原 QRS积分 心室重构
分 类 号:R541.4[医药卫生—心血管疾病]
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