主动脉球囊反搏对再灌注不良的急性前壁心肌梗死患者血浆脑钠素和心功能的影响  

Effect of Intra-aortic Ballon Pump in Patients with Acute Anterior Myocardial Infarction after Unsuccessful Reperfusion Therapy on Serum Brain Natriuretic Peptide and Cardiac Function

作　　者：冯春光[1,2,3] 杨向军[1] 付强[2,3] 王彦炯[2,3] 曹秋玫[2,3] 阮红云[2,3] 

机构地区：[1]苏州大学附属第一医院心内科,江苏省苏州市215006 [2]江苏省徐州市心血管病研究所 [3]江苏省徐州市中心医院心内科

出　　处：《中国全科医学》2013年第1期43-46,共4页Chinese General Practice

基　　金：国家自然基金项目(K112213810);"江苏省医学领军人才"项目(LJ201140)

摘　　要：目的评价主动脉球囊反搏(IABP)对急性前壁ST段抬高(再灌注不良)心肌梗死患者治疗的有效性和安全性及对血浆脑钠素(BNP)、左室舒张末期直径(LVEDD)、左室射血分数(LVEF)值的影响。方法再灌注不良心肌梗死患者40例,在最优药物治疗基础上按是否应用IABP分为A组(IABP植入组,20例)、B组(对照组,20例)。免疫化学发光法测患者入院后1、7、90 d血浆BNP浓度,超声心动图测入院后1、7d以及90d LVEDD、LVEF值。结果入院后1 d两组BNP和LVEDD、LVEF值差异均无统计学意义(P>0.05)。入院后7 d、90 d A组BNP低于B组,差异均有统计学意义〔(692±153)pg/ml vs.(805±151)pg/ml,P<0.05;(587±191)pg/ml vs.(722±174)pg/ml,P<0.05〕。入院后7d A组、B组LVEDD值和LVEF值差异均无统计学意义(P>0.05)。入院后90 d,A组LVEDD值明显低于B组,差异有统计学意义〔(55±2)mm vs.(58±3)mm,P<0.05〕,LVEF值差异无统计学意义(P>0.05)。结论在最优药物治疗基础上,IABP能进一步降低再灌注不良的急性前壁ST段抬高心肌梗死患者BNP值,改善心功能指标。Objective To evaluate the effectiveness and the safety of intra-aortic balloon pump（IABP） in patients with acute anterior myocardial infarction after unsuccessful reperfusion therapy and its effect on the concentration of serum brain natriuretic peptide（BNP） and the values of left ventricular end-diastolic diameter（LVEDD） and left ventricular ejection fraction（LVEF）. Methods Forty patients with acute anterior myocardial infarction,who underwent unsuccessful reperfusion therapy and optimal medication,were divided as IABP group（receiving IABP,n=20） and control group（not receiving IABP,n=20）.At 1,7,90 days after admission the plasma concentration of BNP was measured by chemiluminescence immunoassay,and LVEDD and LVEF were measured by echocardiography. Results On the 1st day of admission,there were no statistical difference between the two groups in values of BNP,LVEDD and LVEF.On the 7th day and the 90th day of admission,the values of BNP in the IABP group were lower than those in the control group（（692±153）pg/ml vs.（805±151）pg/ml,P0.05;（587±191）pg/ml vs.（722±174）pg/ml,P0.05）.On the 7th day of admission,no statistical difference was found between the two groups in values of LVEDD and LVEF（P0.05）.On the 90th day of admission,the value of LVEDD in the IABP group were lower than those in the control group（（55±2）mm vs.（58±3）mm,P0.05）,but in value of LVEF no statistical difference was found（P0.05）. Conclusion On the basis of optimal medication,IABP can further lower the BNP level in patients with acute anterior myocardial infarction after unsuccessful reperfusion therapy,and improve their cardiac functions.

关 键 词：心肌梗死 主动脉内球囊反搏术 脑钠肽 左室舒张末期直径 左室射血分数 

分 类 号：R542.22[医药卫生—心血管疾病]