非糖尿病患者急性心肌梗死再灌注后微量白蛋白尿与心功能的变化  

Microalbuminuria and Cardiac Functional Changes in Non-Diabetic Patients With Acute Myocardial Infarction After Successful Revascularization

作　　者：阮蕾[1] 罗彩东[2] 闫亚非[1] 王羽[2] 吴屹[2] 郑铿[1] 陈航[1] 刘童[1] 秦方[1] 王静[1] 汤雁蓉[1] 张静[1] 付莉[1] 

机构地区：[1]成都市第一人民医院心内科,四川省610041 [2]四川省绵阳市中心医院心内科

出　　处：《中国循环杂志》2012年第6期419-422,共4页Chinese Circulation Journal

摘　　要：目的:本研究旨在评价非糖尿病患者急性心肌梗死成功再灌注后微量白蛋白尿对心功能的预后价值。方法:225例非糖尿病急性心肌梗死成功再灌注患者根据微量白蛋白尿是否阳性,分为微量白蛋白尿阳性组(n=124)和微量白蛋白尿阴性组(n=101)。观察两组患者再灌注治疗后24小时T波倒置和2小时ST段下降幅度;心肌梗死急性期、3个月和6个月时的左心室大小和左心室射血分数以及血浆脑钠肽的水平。结果:两组患者在年龄、性别、体重指数、吸烟、高血压史、心绞痛史、心肌梗死史、心律失常等方面差异均无统计学意义(P均>0.05)。再灌注后微量白蛋白尿阳性组24小时T波倒置及2小时ST段完全回落明显低于微量白蛋白尿阴性组(P<0.05);再灌注后微量白蛋白尿阳性组24小时T波无倒置和2小时ST段部分回落和无回落明显高于微量白蛋白尿阴性组(P<0.05),差异均有统计学意义。微量白蛋白尿阳性组与微量白蛋白尿阴性组比较,微量白蛋白尿阴性组6个月时左心室舒张末期容积高、左心室射血分数低(P均<0.05),差异均有统计学意义。3个月及6个月时血浆脑钠肽水平明显升高,微量白蛋白尿阳性组及微量白蛋白尿阴性组组内分别比较:心肌梗死急性期、3个月和6个月血浆脑钠肽呈下降趋势,差异均有统计学意义(P均<0.05)。结论:本研究结果提示,在非糖尿病急性心肌梗死成功再灌注患者中,微量白蛋白尿是心功能变化的预测指标。Objective： To evaluate the microalbuminuria（MAU） and cardiac functional changes in non-diabetic patients with acute myo- cardial infarction（AMI） after successful revascularization. Methods： A total of 225 related patients were divided into 2 groups as MAU＋group,n= 124 and MAU- group,n= 101. The ST segment decline after 2h of percutanous coronary intervention（PCI） ,T wave inversion after 24h of PCI,the size of left ventricle,left ventricular ejection fraction（LVEF） ,plasma BNP level at the acute stage of MI,3 and 6 months after MI were evaluated and compared between 2 groups. Results ： There were no statistic differences in age, gender, BMI, smoking, the history of hypertension, angina, MI and arrhythmia between 2 groups, all P〉0. 05. The patients with ST segments decline after 2h of PCI and T wave inversion after 24h of PCI in MAU＋ group were less than those in MAU- group, P〈0. 05. Compared with MAU- group, MAU＋ group had increased left ventricular end-diastolic volume and decreased LVEF at 6 months after MI. Plasma BNP level at acute stage ,3 and 6 months after MI were decreasing within each group, all P〈0. 05. Conclusion ： Microalbuminuria is a predictor for cardiac functional changes in non-diabetic patients with AMI after successful revascularization.

关 键 词：非糖尿病 急性心肌梗塞 微量白蛋白尿 

分 类 号：R541[医药卫生—心血管疾病]