AMI-PCI应用冻干重组人脑利钠肽对左室重构的影响  

Effects of rhBNP on left ventricular remodeling of patients with AMI-PCI

作　　者：孙阿林 潘斌[2] 周鹏[1] 张国强[3] 李晓东[1] 王健[4] 

机构地区：[1]潍坊医学院内科学教研室,山东潍坊261052 [2]潍坊医学院临床技能实验室,山东潍坊261052 [3]潍坊医学院儿科学教研室,山东潍坊261052 [4]潍坊市人民医院心内科,山东潍坊261041

出　　处：《实用药物与临床》2016年第1期30-34,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的研究急诊PCI静脉应用冻干重组人脑利钠肽(rh BNP)对急性心梗患者左室重构指标及炎症因子水平的影响。方法选取急性心肌梗死患者38例,随机分为rh BNP治疗组(rh BNP组)和常规治疗组(常规组),每组19例,两组患者在术前、术后给予常规治疗的基础上,rh BNP组在PCI术前静脉推注负荷量rh BNP,再以0.007 5μg/(kg·min)维持静脉持续泵入直至术后72 h,常规组术前给予50μg/min硝酸甘油维持静脉持续泵入直至术后72 h,分别测定两组患者PCI术前和术后3个月左室彩超指标及术前、术后72 h、术后3个月血浆NT-pro BNP、Ald、CRP、IL-6水平。结果 PCI术后72 h、3个月NT-pro BNP、Ald水平与PCI术前组内比较,差异均有统计学意义(P<0.05或P<0.01);PCI术后72 h NT-pro BNP、Ald水平与PCI术后3个月组内比较,除常规治疗组Ald水平外,差异均有统计学意义(P<0.05);两组PCI术后72 h、3个月对应指标组间比较,差异均有统计学意义(P<0.05)。PCI术后72 h、3个月CRP、IL-6水平与PCI术前组内比较,除常规治疗组术后72 h IL-6水平外,差异均有统计学意义(P<0.05或P<0.01);PCI术后72 h CRP、IL-6水平与PCI术后3个月组内比较,除常规治疗组IL-6水平外,差异均有统计学意义(P<0.05);两组PCI术后72 h、3个月对应指标组间比较,差异均有统计学意义(P<0.05)。PCI术后3个月左心室各指标与PCI术前组内比较,除常规治疗组LVDd、LVPWT水平外,差异均有统计学意义;两组PCI术后3个月左心室对应指标组间比较,差异均有统计学意义(P<0.05或P<0.01)。结论急性心肌梗死患者急诊PCI静脉应用冻干重组人脑利钠肽可抑制炎症因子水平,改善心室重构。Objective To study the effects of rhBNP on left ventricular remodeling indicators and inflammatory cytokines plasma level of AMI-PCI patients.Methods Thirty-eight acute myocardial infarction patients were randomly divided into rhBNP treatment group（rhBNP group） and routine treatment group（routine group）,19 cases in each group.All the patients received conventional treatment.Patients in rhBNP group were given intravenous push load rhBNP before PCI,and continuous intravenous rhBNP at 0.007 5 μg/（kg·min） till 72 h after PCI.Patients in routine group were given continuous intravenous rhBNP at 50 μg/kg till 72 h after PCI.The ultrasonography of left ventricular before PCI and at 3 months after PCI were observed,and the plasma NT-proBNP,Ald,CRP,IL-6 levels before PCI（T0）,at 72 h（T1） and 3 months（T2） after PCI were detected.Results The NT-proBNP andAldat T1 in the two groups were higher than those at T0（P〈0.05 or P〈0.01）,and the NT-proBNP and Ald at T2were lower than those at T0 and T1（P〈0.05 or P〈0.01）,the Ald in routine group at T2was lower than that at T0（P〈0.01）;There were significant differences in NT-proBNP and Ald at T1 and T2 between the two groups（P〈0.05）.The GRP and IL-6 in the two groups at T2 were lower than those at T0（P〈0.05 or P〈0.01）,the CRP and IL-6 in rhBNP group and CRP in rontine group at T1 were lower than those at T0（P〈0.05）;The CRPand IL-6 in rhBNP group and CRP in routine group at T2 were lower than those at T1（P〈0.05）;There were significant differences in CRP and IL-6 at T1 and T2between the two groups（P〈0.05）.The LVDd,IVST,LVPWT,LVMI in rhBNP group and IVST,LVMI in routine group at T1 were lower than those at T0（P〈0.05 or P〈0.01）;There were significant differences in LVDd,IVST,LVPWT,LVMI at T1 between the two groups（P〈0.05）.Conclusion Intravenous application of freeze-dried recombinant human brain natriuretic peptide on AMI-PCI patient can inhibit the levels of inflammatory factor and improve ventrica

关 键 词：急性心肌梗死 冻干重组人脑利钠肽 炎症因子 心室重构 PCI 

分 类 号：R542.22[医药卫生—心血管疾病]