rhBNP对急性心肌梗死早期高危患者心功能及左室重塑的影响  

Influences of recombinant human brain natriuretic peptide on heart function and left ventricular remodeling in high risk patients with early acute myocardial infarction

作　　者：乔慧斌[1] 李莉[1] 郭任维[1] 李建国[1] 王全义[1] 

机构地区：[1]山西医科大学附属汾阳医院心内科,汾阳032200

出　　处：《中国循证心血管医学杂志》2015年第2期218-220,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的研究重组人脑利钠肽（rh BNP）对急性心肌梗死早期高危患者早期心功能及左室重塑的影响。方法选取2013年1月至2014年09月山西医科大学附属汾阳医院心内科收治的首次急性心肌梗死（AMI）患者52例,男性28例,女性24例,年龄41~75岁,平均年龄（60.8±9.8）岁。所有患者随机分为rh BNP组（n=23）和对照组（n=29）。对照组仅给予常规治疗,rh BNP组在常规治疗的基础上静脉泵入rh BNP3~5 d。测定两组患者入院即刻、入院1周后N末端脑钠肽前体（NT-pro BNP）、左室射血分数（LVEF）、左室舒张末期内径（LVEDd）,记录1周后心功能Killip分级、心源性死亡。结果两组入院1周后临床心功能Killip分级情况以及心源性死亡比例比较,差异无统计学意义（P均〉0.05）。与治疗前比较,治疗后对照组NT-pro BNP水平升高,rh BNP组降低,差异有显著统计学意义（P均〈0.01）。两组治疗后较治疗前LVEF升高,LVEDd增加,差异有统计学意义（P均〈0.05）。与对照组治疗后比较,rh BNP组NT-pro BNP水平降低[（2204.94±830.90）pg/ml vs.（1498.29±707.33）pg/ml],LVEDd减少[（53.60±5.25）mm vs.（49.87±3.36）mm],差异有明显统计学意义（P均〈0.01）。结论 AMI早期高危患者及早应用rh BNP治疗可以有效改善心功能、抑制早期左室重塑。Objective To study the influences of recombinant human brain natriuretic peptide （rhBNP） on heart function and left ventricular remodeling in high risk patients with early acute myocardial infarction （AMI）. Methods The patients [n=52, male 28, female 24, aged from 41 to 75 and average age=（60.8±9.8）] with first time AMI were chosen from Jan. 2013 to Sept. 2014. All patients were randomly divided into rhBNP group （n=23） and control group （n=29）, and control group was given only routine therapy and rhBNP group was given rhBNP for 3-5 d besides of routine therapy. The changes of NT-proBNP, LVEF and LVEDd were detected immediately and 1 w after hospitalization, and Killip scores and cardiac death were recorded after 1 w.Results The difference in Killip scores and percentage of cardiac death had no statistical significance between 2 groups 1 w after hospitalization （all P＆gt;0.05）. The level of NT-proBNP increased in control group and decreased in rhBNP group after treatment （all P〈0.01）, and LVEF and LVEDd all increased in 2 groups after treatment （allP〈0.05）. After treatment, NT-proBNP level decreased [（2204.94±830.90） pg/mlvs. （1498.29±707.33） pg/ml] and LVEDd decreased [（53.60±5.25） mm vs. （49.87±3.36） mm] in rhBNP group compared with control group （P〈0.01）.Conclusion The administration of rhBNP as early as possible can effectively improve heart function and inhibit early left ventricular remodeling in high risk patients with early AMI.

关 键 词：重组人脑钠肽 急性心肌梗死 心功能 左室重塑 

分 类 号：R541.4[医药卫生—心血管疾病]