重组人脑利钠肽对急性心肌梗死经皮冠状动脉介入治疗术后心力衰竭患者心肌酶、梗死面积的影响  

Influence of recombinant human brain natriuretic peptide on cardiac enzymes and infaretion area in patients with heart failure after acute myocardial infarction and percutaneous intervention

作　　者：吴春涛 马士新[2] 

机构地区：[1]上海市第六人民医院金山分院心内科,上海201599 [2]上海市第六人民医院心内科

出　　处：《中国介入心脏病学杂志》2016年第7期394-397,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的研究分析重组人脑利钠肽(rh BNP)对急性心肌梗死(AMI)行经皮冠状动脉介入治疗(PCI)术后发生心力衰竭患者心肌酶、梗死面积的影响。方法选择上海市第六人民医院收治的AMI行PCI术后发生心力衰竭的患者86例,遵循随机分组原则分为rh BNP组(43例)和对照组(43例)。rh BNP组给予静脉泵入rh BNP治疗,对照组给予静脉泵入硝酸甘油治疗。观察并对比两组患者的心肌酶学水平及心肌梗死面积。结果 rh BNP组疗效的总有效率显著高于对照组(90.7%比72.1%,P=0.027),差异有统计学意义;肌酸激酶峰值[(1278.62±832.34)mol/L比(1697.75±958.63)mol/L,P=0.033]、肌酸激酶同工酶峰值[(123.84±76.53)mol/L比(172.74±93.56)mol/L,P=0.01]、肌钙蛋白I[(11.46±3.45)μg/L比(16.78±3.51)μg/L,P<0.001]、心肌梗死面积[(7.86±1.49)cm^2比(8.83±2.26)cm^2,P=0.021]均显著低于对照组,差异均有统计学意义;而两组患者侧支循环、术前TIMI分级及术后即刻TIMI分级比较,差异均无统计学意义(均P>0.05)。结论 rh BNP可改善AMI行PCI术后发生心力衰竭患者的心肌灌注,减小梗死面积,治疗显著,且预后良好,值得应用推广。Objective To study the effect of recombinant human brain natriuretic peptide （rhBNP）on cardiac enzymes and infarction area in patients with heart failure after AMI and PCI.Methods 86 AMI patients with heart failure after PCI were randomly divided into the rhBNP group （n =43） and the control group （n =43）.The rhBNP group was given intravenous infusion of rhBNP while the control group was given intravenous infusion of nitroglycerin.The level of cardiac and the size enzyme of infarct area were compared between the two groups.Results The overall curative effection rate was higher in the rhBNP group （90.7％ vs.72.09％,P =0.027）.The peak levels of creatine kinase （CK）,creatine kinase isoenzyme MB （CK-MB） and cardiac troponin I （cTnI） and the area of myocardial infarction were lower in the rhBNP group than the control （all P ＜ 0.05）.There were no statistical differeaces between the 2 groups in collateral circulation,preoperative TIMI grade and TIMI grade immediately after operation （P ＞ 0.05）.Conclusions RhBNP can improve the myocardial perfusion in patients with heart failure after AMI intervention and reduce the infarct size.The therapentic effect is significant with good prognosis.

关 键 词：重组人脑利钠肽 急性心肌梗死 心力衰竭 心肌酶 

分 类 号：R542.22[医药卫生—心血管疾病]