磷酸肌酸钠联合冻干重组人脑利钠肽对急性ST段抬高型心肌梗死患者心电图及血清MMP-9 NT-proBNP水平的影响  

Effects of creatine phosphate sodium combined with lyophiluzed recombinant human brain natriuretic peptide on ECG and serum MMP-9,NT-proBNP levels in patients with acute ST-segment elevation myocardial infarction

作　　者：邢钰[1] 白中乐[1] 刘宇宙[1] 李凌[1] Xing Yu;Bai Zhongle;Liu Yuzhou;Li Ling(First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《临床心身疾病杂志》2019年第3期12-16,共5页Journal of Clinical Psychosomatic Diseases

基　　金：国家自然科学基金青年科学基金项目(编号81600290).

摘　　要：目的探讨注射用磷酸肌酸钠联合冻干重组人脑利钠肽对急性ST段抬高型心肌梗死患者心电图及血清N末端B型钠尿肽原、基质金属蛋白酶-9水平的影响。方法将96例急性ST段抬高型心肌梗死患者按随机数字表法分为两组,各48例。对照组采用常规治疗,在此基础上观察组采用注射用磷酸肌酸钠联合冻干重组人脑利钠肽治疗,观察2周,随访1个月,比较治疗前后两组心功能、尿量、呼吸困难评分,检测血清N末端B型钠尿肽原、基质金属蛋白酶-9水平及心电图变化,统计不良心血管事件发生情况。结果(1)观察组治疗总有效率为89.6%,对照组为70.83%,观察组显著高于对照组(P<0.05);(2)治疗后观察组左心室舒张末期内径、左心室收缩末期内径值显著低于对照组(P<0.01),左心室射血分数显著高于对照组(P<0.01);(3)治疗后观察组血清N末端B型钠尿肽原、基质金属蛋白酶-9水平显著低于对照组(P<0.01);(4)治疗后观察组尿量显著多于对照组,呼吸困难评分显著低于对照组(P<0.01);(5)随访1个月,观察组不良心血管事件发生率为6.2%,对照组为22.9%,观察组显著低于对照组(P<0.05)。结论注射用磷酸肌酸钠联合冻干重组人脑利钠肽治疗急性ST段抬高型心肌梗死临床疗效显著,可明显改善患者心电图及心功能,降低血清N末端B型钠尿肽原、基质金属蛋白酶-9水平及不良心血管事件发生率。Objective To investigate the effect of creatine phosphate sodium combined with lyophiluzed recombinant human brain natriuretic peptide on ECG and serum MMP-9,NT-proBNP levels in patients with acute ST-segment elevation myocardial infarction.Methods 96 patients with acute ST-segment elevation myocardial infarction were divided into two groups according to the random number table,48 cases each.The control group was treated with conventional therapy.On the basis of this,the observation group was treated with creatine phosphate sodium for injection combined with lyophiluzed recombinant human brain natriuretic peptide.Both groups were observed for 14 d,followed up for 1 month.Cardiac function,urine volume,and dyspnea score of the two groups were compared before and after treatment,The changes of NT-proBNP,MMP-9 levels and ECG were detected,and the incidence of adverse cardiovascular events was count.Results(1)ECG efficacy:The total effective rate of treatment group(89.58%)was higher than that of the control group(70.83%)(P<0.05);(2)Cardiac function:Compared with the control group,the LVSd and LVDd values were lower and the LVEF was higher after treatment(P<0.01);(3)The levels of serum NT-proBNP and MMP-9 in the observation group were lower than those in the control group(P<0.01);(4)Compared with the control group,the urine volume in the observation group was higher and the dyspnea score was lower(P<0.05);(5)After 1 month follow-up,the incidence of adverse cardiovascular events in the observation group(6.2%)was lower than that in the control group(22.9%)(P<0.05).Conclusion Creatine phosphate sodium for injection combined with lyophilized recombinant human brain natriuretic peptide for STEMI can improve ECG and cardiac function,and reduce serum NT-proBNP,MMP-9 levels and adverse cardiovascular events,with significant clinical efficacy.

关 键 词：急件ST段抬高型心肌梗死 注射用磷酸肌酸钠 冻干重组人脑利钠肽 N末端B型钠尿肽原 基质金属蛋白酶-9 

分 类 号：R542.22[医药卫生—心血管疾病]