rhBNP对急性前壁心肌梗死合并心力衰竭患者左心功能及远期左心室重构的影响  

Effects of recombinant human brain natriuretic peptide on ventricular function and long-term left ventricular remodeling in patients with anterior wall acute myocardial infarction complicated by heart failure

作　　者：孟晓京[1] 李晓刚[1] 杨红梅[1] 

机构地区：[1]河北省秦皇岛市第一医院心内一科,06600

出　　处：《河北医药》2013年第16期2405-2407,共3页Hebei Medical Journal

摘　　要：目的研究静脉应用重组人脑利钠肽(rhBNP)对经皮冠状动脉介入治疗(PCI)的急性心肌梗死合并心力衰竭患者左心功能和远期左心室重构的影响。方法将60例首发急性前壁ST段抬高心肌梗死合并急性心力衰竭患者随机分为rhBNP组和对照组,每组30例。比较2组患者治疗24 h的心功能改善情况、呼吸困难程度、整体临床状况、尿量的变化。监测2组治疗前及治疗后24 h、48 h血浆NT-proBNP水平,以及治疗前及治疗后肾素、血管紧张素Ⅱ、醛固酮水平。观察2组患者治疗后24 h、出院时及出院后6个月时心功能及左心室重构变化。结果用药后24 h rhBNP组患者呼吸困难程度、尿量、尿量与入量的差值、EF值、Tei指数与对照组比较,差异有统计学意义(P<0.05);与对照组相比,治疗48 h时,rhBNP组的血浆rhBNP、肾素、血管紧张素Ⅱ及醛固酮水平下降更明显(P<0.05);2组患者好转出院时,左心室舒张末期容积(LVEDV)差异无统计学意义(P>0.05),而rhBNP组EF值及Tei指数较对照组明显升高(P<0.05);出院后6个月时,rhBNP组Tei指数、EF值较对照组仍明显升高(P<0.05),而rhBNP组LVEDV及ΔLVEDV%较对照组降低(P<0.05)。结论 rhBNP能有效改善急性心肌梗死后心力衰竭患者的呼吸困难和临床状况,并且可以延缓远期心室重构,改善远期心功能。Objective To evaluate the influence of recombinant human brain natriuretie peptide （rhBNP） on ventricular function and long - term left ventricular remodeling （LVR） in patients with anterior wall acute myocardial infarction （AMI） complicated by heart failure who were treated by percutaneous coronary intervention （PCI）. Methods Sixty patients with acute anterior myocardial infarction complicated by heart failure for the first time were randomly divided into rhBNP treatment group and control group, with 30 patients in each group. The improvement status of cardiac function, dyspnea degree, overall clinical condition and urine volume were observed and compared between the two groups at 24 hours after treatment. The NT-proBNP levels were detected at baseline and 24 hours ,48 hours after treatment. The plasma levels of rennin, angiotensin 11 and aldosterone were determined before and after treatment. The changes of cardiac function and LVR at 24 hours after treatment, discharge from hospital and at 6 months after discharge for both groups. Results There were significant differences in dyspnea degree, urine volume, the difference between urine output and urine intake, EF value, Tei index between rhBNP treatment group and control group at 24h after treatment （ P 〈 0.05 ）. As compared with that in control group,the decrease degree of plasma NT-proBNP, rennin, angiotensin 11 and aldosterone in rhBNP treatment group was more obvious at 48 hours after treatment （ P 〈 0.05 ）. There was no significant difference in LVEDV at discharge from hospital between two groups, however, EF value and Tei index in rhBNP treatment group were obviously increased, as compared with those in control group （ P 〈 0.05 ）. At 6 months after discharge, the EF value and Tei index in rhBNP treatment group were still higher than those in control group （ P 〈 0.05 ）, but LVEDV and ALVEDV% in rhBNP group were significantly lower than those in control group （ P 〈 0.05 ）. Conclusion The rhBNP can improve effecti

关 键 词：重组人脑利钠肽 急性心肌梗死 急性心力衰竭 左心室重构 TEI指数 

分 类 号：R542.22[医药卫生—心血管疾病]