重组人脑利钠肽对急性心肌梗死泵功能衰竭患者心肌重构的影响分析  

Influence of Recombinant Human Brain Natriuretic Peptide on Cardiac Remodeling in Patients with Myocardial Infarction with Pump Failure

作　　者：徐峰[1] 杨学成[1] 程璐[1] 卢云凤[1] 王冲[1] 

机构地区：[1]中国医科大学附属第一医院心血管内科,辽宁省沈阳市110001

出　　处：《中国全科医学》2013年第9期974-976,共3页Chinese General Practice

基　　金：辽宁省教育厅(L2010692)

摘　　要：目的探讨重组人脑利钠肽对急性心肌梗死(AMI)合并泵功能衰竭患者心肌重构的影响。方法选择2009年5月—2010年4月我院收治的118例AMI合并泵衰竭的患者为研究对象,按照随机数字表法分为对照组和试验组。对照组采用常规治疗,试验组在对照组基础上给予重组人脑利钠肽治疗。在治疗前和治疗1年后对患者行心脏超声检查,并在治疗前和治疗2周时检测血清B型利钠肽(BNP)、去甲肾上腺素(NE)、内皮素-1(ET-1)、抗利尿激素(ADH)、肌酐(Cr)水平。结果两组患者临床疗效和主要不良心脏事件(MACE)发生率间差异均有统计学意义(P<0.05)。两组患者治疗前左室射血分数(LVEF)、左室舒张末期内径(LVEDD)和左心房内径(LAD)间差异无统计学意义(P>0.05),治疗1年后以上指标间差异均有统计学意义(P<0.05)。治疗2周时试验组患者的BNP、NE、ET-1水平均低于对照组,差异有统计学意义(P<0.05)。结论重组人脑利钠肽对心肌梗死泵功能衰竭患者心肌重构有良好的抑制效果,并可改善患者心脏血流动力学功能,改善患者预后。Objective To explore the influence of recombinant human brain natriuretic peptide （BNP） on myocardial remodeling in patients with acute myocardial infarction （AMI） with pump failure. Methods 118 AMI patients with pump failure admitted to our hospital from May 2009 to April 2010 were randomly divided into control group and experiment group. The control group was given routine treatment, while the experiment group was given recombinant human BNP in addition to routine treat- ment. Cardiac ultrasound examination was conducted before treatment and one year after treatment. Serum BNP, norepinephrine （NE）, endothelin -1 （ET- 1 ）, antidiuretic hormone （ADI-I） and creatinine （Cr） were detected before treatment and after two weeks treatment. Results The clinical efficacy and major adverse cardiac events （MACE） between the two groups showed statisffcally significant differences （P 〈 0. 05 ） . Before treatment, the LVEF, LVEDD and LAD between the two groups showed no statistically significant difference （P 〉 0. 05 ）, but one year after treatment the above mentioned indicators all showed statisti- cally significant differences （ P 〈 0. 05） . After two weeks treatment, the levels of BNP, NE and ET - 1 in experiment group were significantly lower than the control group （ P 〈 0. 05 ） . Conclusion The recombinant human brain natriuretic peptide have good inhibitory effect on cardiac remodeling in patients with myocardial infarction with pump failure, and can improve patients＇ cardiac hemodynamic function as well as patients＇ prognosis.

关 键 词：利钠肽 脑 心肌梗死 心室重构 

分 类 号：R542.22[医药卫生—心血管疾病]