急性心肌梗死心力衰竭患者血浆肌钙蛋白Ⅰ、高敏C-反应蛋白和NT-proBNP的变化及心脉隆干预疗效  

Changes of cTnI,hs-CRP and NT-proBNP and the therapeutic effect of Xinmailong on heart failure patients with acute myocardial infarction

作　　者：马琦琳[1] 孔涛[1] 吉绍葵[1] 张赛丹[1] 宁阳根[1] 

机构地区：[1]中南大学湘雅医院心血管内科,湖南长沙410008

出　　处：《中国现代医学杂志》2011年第23期2886-2889,共4页China Journal of Modern Medicine

摘　　要：目的研究急性心肌梗死(acute myocardial infarction,AMI)心力衰竭(简称心梗心衰)患者血浆中肌钙蛋白(Ⅰcardiac troopingⅠ,cTnI)、高敏C-反应蛋白(high-sensitivity creactive protein,hs-CRP)、N末端脑钠肽前体(N-terminal-pro-brain-natriuretic-peptide,NT-proBNP)、肌酸激酶同工酶(creatine kinase-MB,CK-MB)的变化,探讨心脉隆对急性心梗心衰患者干预的疗效。方法选取35例健康者为正常对照组;42例急性心梗心衰患者为心梗组,并随机将其中21例患者分为心脉隆组,21例为常规治疗组,两组均按急性心肌梗死治疗指南进行处置,常规治疗组患者接受抗血小板、抗凝、降脂、扩张冠状动脉、抗心衰等方面治疗,心脉隆组在此基础上加用心脉隆静脉滴注;心脉隆的使用方法为5%的葡萄糖中加入6mL心脉隆2次/d,疗程为14d。结果与正常健康人比较,急性心梗心衰患者肌钙蛋白I、高敏C-反应蛋白、NT-proBNP、肌酸激酶同工酶及左心室收缩末期容量指数(left ventricular end-systolic volume index,LVESVI)均明显升高(P<0.01),左心室射血分数(left ventricular ejection fractions,LVEF)显著下降(P<0.01)。治疗14d后,常规治疗组和心脉隆组患者血肌钙蛋白I、高敏C反应蛋白、NT-proBNP、肌酸激酶同工酶及LVESVI均较治疗前明显下降(P<0.01),LVEF较治疗前显著升高(P<0.01);心脉隆组治疗后血高敏C反应蛋白、NT-proBNP及LVESVI较常规治疗组治疗后明显下降(P<0.01),LVEF较治疗前显著升高(P<0.01)。结论急性心梗心衰患者按常规治疗后心功能明显提高,cTnI、hs-CRP、NT-proBNP和CK-MB显著下降;而加用心脉隆能够进一步提高患者的心功能,使hs-CRP和NT-proBNP进一步下降,改善患者预后。【Objective】 To determine the changes of cTnI,hs-CRP and hs-proBNP and the therapeutic effect of Xinmailong on heart failure patients with acute myocardial infarction（AMI）.【Methods】 Thirty-five healthy controls and 42 heart failure patients with acute myocardial infarction（AMI） were randomly divided into treatment group of Xinmailong and routine treatment group.All patients treated with anti-platelet,anticoagulation,therapies for lowering 1ipids and dilatation of coronary artery and anti-heart failure underwent medicine therapy on AMI guideline,and the patients in treatment group of Xinmailong were added Xinmailong injection which was used twice one day for forteen days and 6 ml of which were added to 5% glucose.【Results】 Compared with the healthy controls,cTnI,hs-CRP,NT-proBNP,CK-MB and LVESVI significantly increased（P〈0.01）,LVEF significantly decreased（P〈0.01） in the heart failure patients with acute myocardial infarction.Compared with pretherapy,cTnI,hs-CRP,NT-proBNP,CK-MB and LVESVI significantly decreased（P〈0.01） and LVEF significantly increased（P〈0.01） after 14 days treatment.The hs-CRP,NT-pro-BNP and LVESVI in the treatment group of Xinmailong were significantly lower（P〈0.01） than the routine treatment group,and LVEF significantly higher（P〈0.01）.【Conclusion】 The routine treatment for acute myocardial infarction patients with heart failure in accordance with the guidelines facilitated the recovery of cardiac function,cTnI,hs-CRP,NT-proBNP and CK-MB decreased significantly,and treatment of Xinmailong could further improve the cardiac function,hs-CRP and NT-proBNP were obviously lower than the routine treatment group.

关 键 词：急性心肌梗死 心力衰竭 肌钙蛋白I 高敏C-反应蛋白 N末端脑钠肽前体 肌酸激酶同工酶 

分 类 号：R542.22[医药卫生—心血管疾病]