NT—proBNP对评估IABP治疗前后心源性休克患者心功能变化的意义  

The value of NT-proBNP in evaluation of cardiac function in patients with cardiogenie shock before and after treated with IABP

作　　者：许国华[1] 区彩文[1] 陈国钦[1] 宋明才[1] 李健豪[1] 林转娣[1] 

机构地区：[1]广州市番禺区人民医院,511400

出　　处：《国际医药卫生导报》2009年第18期22-25,共4页International Medicine and Health Guidance News

摘　　要：目的探讨心源性休克患者经主动脉球囊反搏（IABP）治疗前后N-末端B型尿钠肽（NT—proBNP）的变化及其与心功能的关系。方法58例患者按入选单双数排序分为1ABP组、常规药物治疗组。所有患者均在治疗前和治疗后第5—10天，应用酶联吸附免疫法试验（ELISA）测定血浆NT—proBNP浓度。心功能测定：采用Swan2Ganz漂浮导管测定治疗前后血液动力学参数，超声心动图检查。观察各组NT—proBNP的变化及与心功能的关系。结果IABP和常规药物治疗两组治疗后NT—proBNP值均明显减少，差异均有统计学意义，IABP组治疗后NT—proBNP每日下降幅度均较常规药物组明显，差异均有统计学意义。另一方面，IABP组治疗后，平均肺动脉压（MPAP）、肺毛细血管嵌压（PCWP）较治疗前明显下降，动脉收缩压（SBP）、心脏指数（CI）较治疗前明显上升，差异有统计学意义；IABP组治疗后MPAP和PCWP各值下降幅度均大于常规药物治疗组，SBP及CI上升幅度大于常规药物治疗组，差异有显著性。结论IABP对于心源性休克患者能在一定程度上改善泵功能及降低血NT—proBNP值，NT—proBNP可以客观准确评价心功能，可作为临床诊断心衰的实验室指标之一。Objective To evaluate the relationship of cardiac function and serum N-terminal proBNP level in patients with cardiogenic shock before and after treated with intra-aortic balloon pump （IABP）. Methods Fifty eight patientswith cardiogenic shock divided into IABP group （29 cases） and Dopamine group（29cases）, respectively. Henmdynamic indexes were measured by Swan-Ganz catheter, The cardiac function were measured by the modified Simoson＇s equation with e-chocardiograph, enzyme linked immunosorbent assayswas used to measure the level of Nterminal proBNP before treatment and after treatment at 5 days and 10 days. Results The level of NT-proBNP were dropped significantly than before treatment in two groups.IABP group was lower than dopamine in group at every day on the NT-proBNP after treatment, there were significantly difference in two groups.On the other hand, Mean pulmonary artery pressure （MPAP） and pulmonary capillarywedged pressure （PCWP） were dropped, systolic blood pressure （SBP） and cardial index （CI） were higher significantly than before treatment in two groups, otherwise, IABP was prevailing over dopamine in the extend of dropping MPAP and PCWP and in the extend of rising SBP and CI, there were significanty statistical difference in two groups. Conclusion IABP can significantly advance the cardiac function and serum N-terminal proBNP level of the patients of cardiogenic shock.NT-proBNPcan objectively evaluate the cardiac function, and it can be used as a marker of clinical diagnosis of heart failure.

关 键 词：心源性休克 主动脉内球囊反搏术 N-末端B型尿钠肽 

分 类 号：R541[医药卫生—心血管疾病]