急性ST段抬高型心肌梗死患者血浆NT—proBNP水平与早期运动耐量的关系研究  

Relationship between plasma N - terminal pro - B - type natriuretic peptide level and early exercise tolerance in the patients with acute ST - segment elevation myocardial infarction

作　　者：李彬[1] 朱锐[1] 吴校林[1] 张民[1] 马可忠[1] 刘文卫[1] 

机构地区：[1]襄樊市中心医院心血管内科,湖北441021

出　　处：《中国急救医学》2010年第10期916-919,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的 研究急性ST段抬高型心肌梗死（STEMI）患者血浆N-末端脑钠肽前体（NT-proBNP）水平与早期运动耐量的关系.方法 STEMI患者98例,分为急诊经皮冠状动脉介入治疗（PCI）组37例、择期 PCI组32例和单纯药物治疗组29例,检测入院即刻、出院前2～3 d、1个月时血浆NT-proBNP水平并进行比较;1个月后行运动平板试验,评估患者的早期运动耐量.结果 出院前和1个月时急诊PCI组血浆NT-proBNP水平显著低于择期PCI组和药物治疗组（P〈0.05）.三组患者1个月时血浆NT-proBNP水平较入院即刻和出院前均显著降低（P〈0.05）.急诊PCI组运动平板试验阳性率（16.2%）较择期PCI组（31.2%）和药物治疗组（37.9%）明显降低（P〈0.05）.择期PCI组出院前和1个月时血浆NT-proBNP水平和运动平板试验阳性率与药物治疗组之间差异无统计学意义（P〉0.05）.结论 STEMI患者血浆NT-proBNP水平与早期运动耐量呈负相关趋势.NT-proBNP水平和运动平板试验可以更好评估STEMI患者的预后,指导临床治疗.Objective To study the relationship between plasma N - terminal pro - B - type natriuretic peptide （NT- proBNP） levels and early exercise tolerance in the patients with acute ST - segment elevation myocardial infarction （STEM]）. Methods 98 patients with STEMI were selected and divided into emergency percutaneous coronary intervention （PCI） group （ 37 patients ）, elective PCI group （32 patients） and simple drug treatment group（29 patients）. The plasma NT- proBNP levels were measured at the point of immediate admission, two to three days before discharge and one month respectively. Exercise stress test was executed to evaluate patients ~ early exercise tolerance after one month. Results Plasma NT - proBNP levels was significantly lower in emergency PCI than in elective PCI group and drug treatment group before discharge and one month （ P 〈 0.05 ）. The plasma NT - proBNP levels of three groups at one nmnth was significantly lower than that at the point of immediate admission and before discharge （ P 〈 0.05 ）. Exercise stress test positive rate of emergency PCI group （16.2%） was significantly lower than that of elective PCI group （31.2%） and drug treatment group （37.9%） （P 〈 0.05 ）. There was no significant difference between elective PCI group and drug therapy group in plasma NT - proBNP levels and exercise stress test positive rate before discharge and at one month （P 〉 O. 05 ）. Conclusion There was negative correlation between plasma NT- proBNP levels and early exercise tolerance in the patients with STEMI. Combination of NT - proBNP levels and exercise stress test can better assess the prognosis of patients with STEMI and guide clinical treatment.

关 键 词：急诊 经皮冠状动脉介入治疗(PCI) 急性ST段抬高型心肌梗死 N-末端脑钠肽前体(NT—proBNP) 运动平板试验 

分 类 号：R542.22[医药卫生—心血管疾病]