急性前壁心肌梗死患者急诊经皮冠状动脉介入治疗术后早期应用重组人脑利钠肽对心脏近期保护作用的研究  

Short-term cardioprotective effect of recombinant human brain natriuretic peptide after emergency PCI in patients with anterior wall acute myocardial infarction

作　　者：仝凌[1] 孙帅[1] 李敏[1] 石芳弟 张虹[1] Tong Ling;Sun Shuai;Li Min;Shi Fangdi;Zhang Hong(Department of Cardiology,Shanxi Provincial Peoples′s Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院心血管内科,太原030012

出　　处：《中国药物与临床》2021年第1期21-23,共3页Chinese Remedies & Clinics

摘　　要：目的研究急性前壁心肌梗死患者急诊经皮冠状动脉介入治疗(PCI)后早期应用重组人脑利钠肽(rhBNP)对心脏的近期保护作用。方法60例急性前壁心肌梗死患者入院后行急诊PCI,术后随机分为rhBNP组和对照组,前者即刻持续静脉微量泵入rhBNP 72 h,后者不予泵入rhBNP。分别记录2组患者术前、术后的呼吸频率、心率、收缩压(SBP)、舒张压(DBP)、出入量差和N端脑钠肽前体(NT-proBNP),出院后1月复查NT-proBNP和心脏彩色多普勒超声,记录左室收缩末内径(LVESV)、左室舒张末内径(LVEDV)、左室射血分数(LVEF)。记录出院后1个月的心血管不良事件(MACE)。结果所有患者呼吸频率、心率、SBP、DBP、NT-proBNP均较术前有所下降,且rhBNP组更明显(P<0.05);出院后1个月rhBNP组的LVESV、LVEDV、LVEF均优于对照组(P<0.05),且MACE发生率也低于对照组(P<0.05)。结论急性前壁心肌梗死患者急诊PCI术后早期应用rhBNP可以稳定血流动力学,显著改善心功能,减少近期MACE发生率。Objective To investigate the short-term cardioprotective effect of recombinant human brain natriuretic peptide(rhBNP)in patients with anterior wall acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI).Methods Sixty patients with anterior wall AMI underwent emergency PCI after admission,and were randomly divided into rhBNP group and control group after the procedure.The rhBNP group received intravenous micro-pumping of rhBNP for 72 h,with the control group did not.The preoperative and postoperative respiratory rate,heart rate,SBP,DBP,fluid balance,and NT-proBNP level were compared between the two groups.At one month post-discharge,the patients were followed up on blood NT-proBNP level and color Doppler echocardiography.The left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV),left ventricular ejection fraction(LVEF)and one-month major cardiovascular adverse events(MACE)were recorded.Results The respiratory rate,heart rate,SBP,DBP,and NT-proBNP level were reduced in all patients after PCI,compared with baseline;the reductions were greater in the rhBNP group(P<0.05).At one month after discharge,the rhBNP group showed more favorable LVESV,LVEDV and LVEF(P<0.05),and lower incidence of MACE(P<0.05),compared with the control group.Conclusion Early administration of rhBNP after emergency PCI in patients with anterior wall AMI can help stabilize hemodynamics,significantly improve cardiac function,and reduce short-term MACE.

关 键 词：心肌梗死 经皮冠状动脉介入疗法 重组人脑利钠肽 

分 类 号：R542.22[医药卫生—心血管疾病]