重组人脑钠肽对急性心肌梗死冠脉未通患者左室重塑和心功能的影响  

Effect of recombinant human brain petide on left ventricular remodeling and ventricular function in patients without successful coronary reperfusion after acute myocardial infarction

作　　者：孙洪涛[1] 韩立坤[1] 包吉日木图[1] 呼日乐巴特[1] 杨炎[1] 

机构地区：[1]内蒙古民族大学附属医院心血管科,通辽市028000

出　　处：《中国心血管病研究》2010年第10期748-752,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的研究重组人脑钠肽（rhBNP）对急性心肌梗死（AMI）冠脉未通患者左室重塑和心功能的影响。方法将103例AMI冠脉未通患者随机分为常规治疗组23例、地高辛组40例、rhBNP治疗组40例，并于AMI后1周、12周、24周分别进行超声心动图分析，测定左室心肌重量，左室收缩功能、舒张功能，了解rhBNP对AMI后左室重塑的阻抑作用。结果①AMI后24周时rhBNP组与常规治疗组和地高辛组比较，室间隔厚度、左室后壁厚度、左室舒张末内径和左室心肌重量指数均明显降低。地高辛组与常规治疗组各项指标比较差异无统计学意义。②AMI后1周时，地高辛组和rhBNP组左室收缩末期容积较常规治疗组降低（P〈0．01），左室射血分数较常规治疗组升高（P〈0．05），两组间差异无统计学意义（P〉0．05）。治疗后12周、24周时，rhBNP组左室舒张末期容积和收缩末期容积较同时间点常规治疗组和地高辛组均显著降低（P〈0．05），而左室射血分数、E／A则显著升高（P〈0．05）。结论rhBNP能明显减轻心肌梗死后心肌肥厚和左室重塑，阻抑左室重塑过程，改善左室功能。Objective To study the inhibitory effect of recombinant human brain petide on left ventricular remodeling and ventricular function in patients without successful coronary reperfusian after acute myocardial infarction （AMI）. Methods A total of 103 patients with AMI and without successful coronary reperfusion were entered into the study. 23 patients were randomized to conventional treatment group,40 patients to digoxin treatment group and 40 patients to rhBNP treatment group. At 1st week, 12th week and 24th week after AMI, the left ventricular myoeardium weight（LVMW） and the parameters of left ventricular systolic and diastolic function were measured by color ultrasound cardiogram. Results （1）At 24th week, IVST,LVPWT,LVDd and LVMI in rhBNP treat- ment group were significantly decreased as compared with conventional treatment group and digoxin treatment group （P〈0.05）. There was no difference in all of the parameters between the conventional treatment group and digoxin treatment group （P〉0.05）. （2）At 1st week, left ventricular end-systolic volume in rhBNP treatment group and digoxin treatment group were significantly decreased compared with that in conventional treatment group （P〈0.01）. While left ventricular ejection fraction increased significantly（P〈0.05 ）. But there was no difference in the parameters between rhBNP and digoxin treatment groups. At 12th week and 24th week, left ventricular end-systolic vol- ume and end-diastolic volume in rhBNP treatment group were significantly decreased compared with those in conventional treatment group and digoxin treatment group （P〈0.05）. While left ventricular ejection fraction and E/A increased significantly（P〈0.05 ）. Condusion rhBNP might significantly reduce myocardial hypertrophy and dilatation of left ventricle, inhibit left ventricular remodeling following AMI and improve the left ventricular function.

关 键 词：重组人脑钠肽 重塑 左室 心肌梗死 心肌再灌注 

分 类 号：R542.22[医药卫生—心血管疾病]