急性广泛前壁心肌梗死患者PCI术后早期血浆N末端脑钠肽前体对心功能的预测价值  

The Value of N Terminal Pro-brain Natriuretic Peptide Prediction on Cardiac Function

作　　者：王立中[1] 程国杰[1] 王文斌[1] 俞晓薇[1] 张银[1] 韩兰唐[1] 曹树军[1] 

机构地区：[1]首都医科大学大兴医院北京市大兴区人民医院,北京102600

出　　处：《医学信息》2013年第5期157-158,共2页Journal of Medical Information

摘　　要：目的探讨急性广泛前壁心肌梗死患者急诊经皮冠状动脉介入治疗fPcI）后早期血浆N末端脑钠肽前体（NT-proBNPl与不同冠脉TIMl分级和及心功能的关系。方法入选74例接受急诊PCI术的急性广泛前壁心肌梗死患者，根据冠脉血流TIMl分级分为1级组（n=18）、2级组（n=26）和3级组（n=30）。于PCI术前、术后4h、12h和24h测定血浆NIT-proBNP浓度，7天行超声心动图检查测定左室射血分数（LVEF）。结果血浆NT-proBNP水平PCI术前无明显差异，术后4h、12h、24hTIMll级组〉TIMl2级组〉TIMl3级组，分别为4h：（988±358）pg／m_l、（865±249）pg／ml和（466±128）pg／ml，P〈0．05；12h：（1986±383）pg／ml、（1379±335）pg／ml和（958±298）pg／ml，P〈0．05；24h：（2658±486）pg／ml、（1938±424）Pg／Inl和（1288±386）pg／ml，P〈0．05。7d时早期NT-proBNP和LVEF呈负相关（r=-O．67，P〈0．01）。结论急性广泛前壁心肌梗死患者PCI术后早期血浆NT-proBNP水平和冠脉TIMl分级及心功能显著相关，可能是早期预测急性心功能不全的重要指标之一。Objective To explore relationship between different TIMI grade of coronary artery flow and cardiac function in patients with acute extensive anterior myocardial infarction and early period amino terminal-pro brain natriuretic peptide （NT-proBNP） after successful primary percutaneous coronary intervention（PCI）.Methods 74 acute extensive anterior myocardial infarction patients treated with primary PCI were included and divided into TIMI1 group（n=18）, TIMI2 group（n=26） and TIMI3 group（n=30） according to coronary artery TIMI grade. Plasma NT-proBNP levels were examined by immunofluorescence method before PCI and 4h, 12h and 24h after onset of AMI and left ventricular ejection fraction （LVEF） were measured by echoeardiography at 7d.Results There was no significant difference in three groups of NT-proBNP before PCI. The levels of N-proBNP were in TIMI1 group 〉 TIMI2 group 〉 TIMI3 group at 4h[（988±358） pg/ml, （865±249） pg/ml and （466±128） pg/ml respectively, P〈0.05], 12h [（1986±383） pg/ml, （1379-±335） pg/ml and （958±298） pg/ml respectively, P〈0.05] and 24h [（2658±486） pg/ml, （1938±424） pg/ml and （1288±386） pg/ml, respectively P〈 0.05]. The value of early period Plasma NT-proBNP was negatively correlated with LVEF at 7d （r=-0.67, P〈0.01）. Conclusion The level of early period plasma NT-proBNP is prominent correlate with different TIMI grade of coronary artery flow and cardiac function in AMI patients treated with primary PCI.

关 键 词：心肌梗死 急性 N末端脑钠肽前体 血管成形术 经皮冠状动脉 

分 类 号：R974.3[医药卫生—药品]