脑利钠肽对急诊冠状动脉介入治疗急性心肌梗死左室结构和功能的评估价值  

Prognostic value of plasma brain natriuretic peptide in patients with acute cronary syndrome underwent percutaneous coronary intervention

作　　者：林敏川 高好考[2] 栾荣华[2] 

机构地区：[1]宝鸡市第二人民医院心内科,陕西宝鸡721000 [2]第四军医大学西京医院心内科

出　　处：《临床心血管病杂志》2010年第7期523-525,共3页Journal of Clinical Cardiology

摘　　要：目的:观察急性心肌梗死(AMI)患者接受急诊经皮冠状动脉介入(PCI)治疗前后的脑利钠肽(BNP)水平变化及其与左室功能,心室重构的关系,探讨BNP在急诊PCI治疗AMI患者预后评估中的作用。方法:入选2008-06-2009-02,发病后12h内接受急诊PCI治疗的ST段抬高型急性心肌梗死(STEMI)患者120例,入院即时及出院时采用酶联免疫法测定患者血浆BNP水平,出院前行超声心动图检测左室射血分数,并根据PCI治疗后7d的BNP水平将患者分为3组:A组<100ng/L,B组为100～400ng/L,C组>400ng/L。所有患者术后6个月进行超声心动图检查,根据左室射血分数、左室舒张末期容积、左室收缩末期容积变化评估左室功能及心室重构。结果:BNP水平与AMI病变范围呈正相关,与左室射血分数呈负相关;PCI治疗后不同心肌梗死部位BNP水平较治疗前均明显下降;3组患者PCI治疗后6个月的超声心动图比较,患者左室射血分数、左室舒张末期容积、左室收缩末期容积B组、C组与A组相比差异有统计学意义(P<0.05),C组与B组比较差异也有统计学意义(P<0.05)。结论:血浆BNP水平可反映AMI的严重程度;BNP增加的程度与梗死的范围呈正相关;AMI患者急诊PCI后BNP水平有显著下降趋势;BNP水平可能可以作为患者左室功能及心室重构的预测因子。Objective：To investigate the changes of brain natriuretic peptide （BNP） of patients with acute myocardial infarction before and after percutaneous coronary intervention （PCI） and its relationship with cardiac function and ventricular remodeling.Method：120 patients with ST segment elevation myocardial infarction were successfully reperfused by primary PCI within 12 hours after onset in 2008-2009.BNP plasma level of the patients was measured with enzyme-linked immunoassay from symptom onset and after out of hospital.7 days after PCI,the patients were divided into 3 groups：group A （100 ng/L）;group B（100～400 ng/L）;group C （400 ng/L）.The patients underwent ultrasound electrocardiogram examination 6 months after PCI to value cardiac function and ventricular remodeling.Result：BNP level of patients after PCI was significantly lower than that before PCI.The results of ultrasound electrocardiogram 6 months after PCI were compared among three groups：the left ventricular ejection fraction,left ventricular end diastolic volume and left ventricular end systolic volume of patients had significant difference between group C and group A,B （P〈0.05）;while it have significant difference between group A and group B （P〈0.05）.Conclusion：BNP level in patients with different part acute myocardial infarction declined after direct PCI,and may be used as the predictor of cardiac function and ventricular remodeling of patients.

关 键 词：ST段抬高性心肌梗死 急诊冠状动脉介入治疗 脑利钠肽 心室重构 

分 类 号：R542.2[医药卫生—心血管疾病]