急性心肌梗死患者急诊冠脉介入术后BNP的应用研究  

Application research on BNP in acute myocardial infarction patients with primary percutaneous coronary intervention

作　　者：田智羽 赵文萍[2] 贾新未[2] 许晶晶[1] 潘焕军[2] 李雅[2] 赵淑君[2] 

机构地区：[1]河北大学,河北保定071000 [2]河北大学附属医院心内科1,河北保定071000

出　　处：《医学研究与教育》2015年第2期24-29,共6页Medical Research and Education

摘　　要：目的分析急性ST段抬高型心肌梗死（ST segment elevtion myocardical infarction,STEMI）患者血浆B-型钠尿肽（B-type natriuretic peptide,BNP）水平与左室室壁运动积分指数（left ventrcular wall motion score index,LVWMSI）之间的关系,并观察不同BNP水平患者180 d内预后情况。方法收集首次发生的STEMI患者64例,均于发病12 h内急诊行冠状动脉介入治疗。依据BNP水平由低到高将所有研究对象分为4组（按4个百分位数）：A组（BNP≤P25：BNP≤115.25 pg/m L）、B组（P26≤BNP≤P50：115.26~200.5 pg/m L）、C组（P51≤BNP≤P75：200.6~409 pg/m L）、D组（BNP≥P76：BNP≥409 pg/m L）。分析各组间LVWMSI的关系以及BNP水平与LVWMSI的相关关系。随访记录180 d内主要心血管不良事件（major adverse cardiac events,MACE）发生情况,并分析其与血浆BNP水平的关系。结果各组间LVWMSI比较差异均有统计学意义（P〈0.05）,BNP水平与LVWMSI呈正相关（r=0.73,P〈0.01）。随血浆BNP水平增高,各组间近期临床心血管事件呈显著增高趋势（P〈0.05）。结论血浆BNP水平能够反应急性心肌梗死患者心功能变化,预测近期预后。Objective To investigate the relationship between plasma Brain natriuretic peptide（BNP） level and left ventricular wall motion score index （LVWMSI） in patients with acute ST-segment elevation myocardial infarction （STEMI）, and the short term prognosis within 180 days. Methods Sixty four patients with STEMI were treated with primary percutaneous coronary intervention （p-PCI） within 12 h of onset. The BNP level was measured on admission. Based on the BNP level, all patients were divided into four groups （according to the 4 percentile）：group A （BNP≤P25：BNP≤115.25 pg/mL）, group B（P26≤BNP≤P50：115.26-200.5 pg/mL）,group C（P51≤BNP≤P75：200.6-409 pg/mL）and group D（BNP≥P76：BNP≥409 pg/mL）. The relationship of BNP level with LVWMSI was analysised. The major adverse cardiac events （MACE） within 180 days were also analyzed. Results The difference of left ventricular wall motion score index among different groups were statistical signiifcant （P ＜ 0.05）. The levels of BNP and LVWMSI was positively related（r=0.73, P ＜ 0.01）. Along with the increase of plasma BNP level, major adverse cardiac events increased signiifcantly （P ＜ 0.05）. Conclusion Plasma BNP level provides information about the change of heart function and short term prognosis for acute myocardial infarction patients.

关 键 词：B-型钠尿肽 室壁运动积分指数 急性心肌梗死 急诊PCI 主要心血管不良事件 

分 类 号：R54[医药卫生—心血管疾病]