脑利钠肽与急性心肌梗死患者预后的临床探讨  

Clinical investigation of the relation of BNP and the prognosis in acute myocardial infarction

作　　者：田玮[1] 付研[1] 王勇[1] 

机构地区：[1]首都医科大学附属北京同仁医院急诊科,100730

出　　处：《北京医学》2007年第6期352-355,共4页Beijing Medical Journal

摘　　要：目的探讨急性心肌梗死患者血浆脑利钠肽(BNP)的浓度与早期诊断及短期预后的临床关系。方法96例急性心肌梗死患者分为灌注治疗组和非灌注治疗组,测定入院时和入院后第7天的血浆BNP浓度,行心电图、血常规、肌酸激酶MB同工酶(CK-MB)、肌钙蛋白I(TnI)及超声心动检查,所有患者自入院起随访30d。结果两组患者在入院时BNP水平均增高,但各组间比较无显著性差异(P>0.05)。入院第7天,灌注组BNP水平为(155.05±88.91)pg/ml,较入院时(307.91±274.37)pg/ml显著降低(P<0.01),而非灌注组前壁心肌梗死BNP水平反而较入院时增高,两者有显著性差异(P<0.05)。第7天BNP浓度与第7天的超声心动检查中左室射血分数(LVEF)呈负相关(r=-0.549,P=0.001),与左室舒张末径(LVEDD)呈正相关(r=0.431,P=0.041)。入院时及第7天BNP浓度与心肌梗死后近期心力衰竭(P1=0.003;P7=0.005)及总心血管不良事件(P1=0.001;P7=0.006)的发生明显相关。结论血浆BNP浓度是心肌梗死后早期心血管事件的预测因子,并有可能用于评估在急性心肌梗死患者中不同治疗方法的疗效。Objective To investigate the relationship between BNP levels and the short-term prognosis in AMI. Methods A total number of 96 acute myocardial infaretion patients were ＂included. They were divided into two groups based on whether accepted PCI was done or not. The rapid plasma＇ BNP levels were measured before treatment and the seventh day after AMI respectively. ECG, blood routine test, CK-MB, TnⅠ and UCG were done. All patients were followed up for 30 days from the day of admission. Results In both groups the BNP levels increased immediately after admission, but there was no significant difference between the two groups. On the seventh day, the BNP levels in PCI group were dramatically decreased （P〈0.05）. On the contrary, in the group without PCI the BNP level of anterior AMI increased （P〈 0.05）. The BNP level on the seventh day was negatively correlated with the LVEF （r=0.549, P=0.001）, but had positive correlation with the LVEDD （r=0.431;/1=-0.041）. The BNP levels of the first day and seventh day were markedly correlated with the occurrence of heart failure （P1=0.003; P7=0.005） and total cardiovascular events （P1=0.001; P7=0.006）. Conclusions The plasma BNP level was a predictor of occurrence of cardiovascular events in AMI patients. The BNP level can be a way to evaluate the treatment efficiency of different treatment approaches in acute myocardial infarction patients.

关 键 词：心肌梗死 脑利钠肽 预后 

分 类 号：R542.22[医药卫生—心血管疾病]