脑钠素(BNP)评价左心室重建术对急性心肌梗死后左心室重构的影响  

BNP in Effect Evaluation of Left Ventricle Reconstruction on Left Ventricular Remolding after Acute Myocardial Infarction

作　　者：白向锋[1] 吴明乐 张桂敏[1] 段玉印[1] 杨百辉[1] 陶杰[1] 

机构地区：[1]昆明医科大学第一附属医院心脏大血管外科,云南昆明650032 [2]四川省南充市中心医院心胸外科,四川南充637000

出　　处：《昆明医科大学学报》2014年第10期30-32,35,共4页Journal of Kunming Medical University

摘　　要：目的评价左心室重建术（室壁瘤闭式折叠术）对左心室重构的影响.方法普通级杂种犬12只作为实验动物,用结扎冠状动脉的方法,建立左心室室壁瘤的实验动物模型,于术前及术后48~72 h分别采集静脉血4 mL,以备进行BNP检测;结扎冠状动脉4周后,将实验犬随机分为实验组、对照组.实验组采用左心室重建术重建左心室,对照组只开胸但不做左心室重建术;在左心室重建术前及术后48-72 h分别采集静脉血4mL,以备进行BNP检测;4周后采集静脉血测量BNP浓度.结果行冠状动结扎术后48-72 h,各组BNP的浓度较术前明显升高（P〈0.05）,提示2组均发生了心室重构,但各组之间比较无统计学意义（P〉0.05）.术后4周BNP浓度与术前比较异常升高（P〈0.05）,可见左心室重构进一步加重,各组之间BNP浓度有差别但并不明显,且无统计学意义（P〉0.05）.行左心室重建术后48-72 h,实验组及对照组BNP浓度较术前有所下降,但并不明显（P〉0.05）.行左心室重建术后4周,实验组与术前比较明显降低（P〈0.05）,实验组BNP浓度与对照组相比,下降明显（P〈0.05）.结论 （1）左心室重建术在一定程度上阻止了左心室重构的发生,其远期效果还有待进一步观察与研究;（2）BNP浓度水平的变化可以较为客观准确地反映左心室重建术对阻止左心室重构的作用.Objective To evaluate the effect of left ventricular reconstruction（closed aneurysm plication）on left ventricular remolding by monitoring the change in brain natriuretic peptide（BNP） concentration. Methods Twelve common dogs were used as experimental animals and the model of ventricular aneurysm was established by the ligation of coronary artery. 4 mL venous blood was collected at 48-72 hours preoperatively and postoperatively for BNP testing. After coronary artery ligation for 4 weeks,the experimental dogs were divided into the experimental group and the control group. The experimental group was conducted left ventricular reconstruction, while open-chest operation was performed in the control group without left ventricular reconstruction. 4 mL venous blood was collected for BNP testing at 48-72 hours preoperatively and postoperatively of left ventricular reconstruction,and BNP concentrations were measured again 4 weeks after operation. Results BNP concentrations were increased in both two groups 48-72 hours after coronary ligation（P〈0.05）,which indicated that ventricular reconstructions were occurred in the two groups. However,there was no significant difference between the two groups.Compared with preoperation,BNP concentrations were increased significantly after 4 weeks（P〉0.05）,which suggested that ventricular remolding have further enhanced,but the difference of BNP concentrations were between the two groups was not obvious, with no statistical significance. BNP concentrations were decreased at 48-72 hours after left ventricular reconstruction in the two groups compared with concentrations before operation,but the difference was not significantly（P〉0.05）. After operation for 4 weeks,BNP concentration in the experimental group were decreased significantly compared with those before operation and the control group（P〈0.05）.Conclusions（1） Left ventricular reconstruction could prevent the occurrence of left ventricular remolding to a certain extent, but the long-term effect rema

关 键 词：脑钠素 左心室重建 左心室重构 心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]