rhBNP对急性心肌梗死患者PCI术后左心功能及左心室重构的影响  

Influence of Recombinant Human Brain Natriuretic Peptide on Left Ventricular Function and Ventricular Remodeling in Patients with AMI-PCI

作　　者：黄丽娟 林施峰 罗瑞英 占德进 林肖彬 HUANG Lijuan;LIN Shifeng;LUO Ruiying(Ningde Hospital Affiliated to Fujian Medical University,Ningde 352000,China)

机构地区：[1]福建医科大学附属宁德市医院,福建宁德352000

出　　处：《中外医学研究》2018年第20期3-5,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2014年福建省卫生计生委青年科研课题立项建议单位资助计划项目(项目编号:2014-2-61)

摘　　要：目的:研究早期静脉应用重组人脑利钠肽(rh BNP)对经皮冠状动脉介入治疗(PCI)的急性心肌梗死患者左心功能和远期左心室重构的影响。方法:选取笔者所在医院2014年5月-2017年5月因急性心肌梗死入院并行急诊PCI的患者共128例,术后随机分为rh BNP组(68例)和对照组(60例)。两组在急诊PCI后进行抗凝、调脂等药物治疗,rh BNP组在此基础上静脉泵入rh BNP 72 h。两组患者均在PCI术前、出院12个月后行心脏超声检查,测定患者左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF),计算TDI-tei指数,左心室舒张末期容积增长率(ΔLVEDV%)。结果:本研究随访12个月,rh BNP组失访18例,对照组失访14例,最终入选rh BNP组50例,入选对照组46例,术后12个月时,rh BNP组的心功能指标LVEF值及Tei指数较对照组改善更明显,差异有统计学意义(P<0.05),rh BNP组左室重构指标△LVEDV%明显低于对照组,差异有统计学意义(P<0.05),rh BNP组主要不良心血管事件发生率低于对照组,差异有统计学意义(P<0.05)。结论:急性心肌梗死患者急诊PCI后在标准治疗的基础上静脉应用rh BNP能改善左室重构,改善左心功能及预后。Objective:To study the added impact of intravenous Recombinant Human Brain Natriuretic Peptide(rhBNP)on left ventricular function and ventricular remodeling in acute anterior myocardial infarction patients with primary PCI followed by conventional treatment.Method:STEMI patients(n=128)were chosen from the Ningde Hospital Affiliated to Fujian Medical University from Mar 2014 to May 2017.All patients were randomly divided into rhBNP group and control group.After PCI,the rhBNP group were given rhBNP 72 hours in veous on the basis of the standard treatment.The indexes of left ventricular enddiastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)were detected before PCI and 12 months after PCI,then TDI-tei index and△LVEDV%were calculated.Major adverse cardiac events(MACE)of patients were recorded during hospitalization and after discharge 12 months.Result:AT 12 months after PCI,LVEF and TDI-tei index were improved in rhBNP group compared with that in control group(P<0.05),There were 6 patients(12.0%)with left ventricular remodeling in rhBNP group and 14 cases(30.4%)in control group after PCI for 6 m(P<0.05).The MACE rate within 12 months of rhBNP group was lower than the control group(P<0.05).Conclusion:The early application of rhBNP after emergency PCI can relieve ventricular remodeling and improve the left ventricular function in patients with AMI-PCI.

关 键 词：RHBNP 急性心肌梗死 经皮冠状动脉介入术 心功能 心室重构 

分 类 号：R542.22[医药卫生—心血管疾病]