急诊冠脉介入治疗对急性心肌梗死患者N末端B型利钠肽原及左心室重构的影响  

Effects of emergency coronary intervention on N-terminal pro-B-type natriuretic peptide and left ventricular remodeling for treating patients with acute myocardial infarction

作　　者：王晓冬[1] 曾波[1] 杜国勇[1] WANG Xiaodong;ZENG Bo;DU Guoyong(Department of Cardiovascular Medicine,the First People′s Hospital of Nanning,Nanning 530022,Guangxi,China)

机构地区：[1]南宁市第一人民医院心血管内科,广西南宁市530022

出　　处：《微创医学》2021年第6期763-766,共4页Journal of Minimally Invasive Medicine

基　　金：广西区卫生厅自筹经费科研课题(编号:Z2007345);广西南宁市青秀区科技局科研项目(编号:2013S05)。

摘　　要：目的探讨急诊冠脉介入治疗对急性心肌梗死患者N末端B型利钠肽原(NT-proBNP)及左心室重构的影响。方法选择急性心肌梗死患者60例,将其随机分成对照组(n=30)和研究组(n=30)。对照组采用常规治疗,研究组在常规治疗的基础上联合急诊冠脉介入治疗。比较两组患者治疗前后的NT-proBNP水平、左心室收缩末期内径(LVESD)和左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD),观察左心室重构情况。结果两组患者的NT-proBNP水平比较,差异有统计学意义(F_(组间)=14.453,P_(组间)=0.002),两组的NT-proBNP水平有随时间降低的趋势(F_(时间)=16.694,P_(时间)=0.002),分组与时间有交互作用(F_(交互)=9.962,P_(交互)=0.019)。其中,治疗1 d、2 d、3 d,研究组的NT-proBNP水平低于对照组(均P<0.05)。治疗3 d时,两组LVESD和LVEDD较治疗前缩小,LVEF较治疗前提升,且与对照组相比,研究组的LVESD和LVEDD缩小更明显,LVEF提升更显著(均P<0.05)。结论急诊冠脉介入治疗能有效降低急性心肌梗死患者体内的NT-proBNP水平,改善患者的心功能,抑制左心室重构。Objective To investigate the effects of emergency coronary intervention on N-terminal pro-B-type natriuretic peptide(NT-proBNP)and left ventricular remodeling in the treatment of patients with acute myocardial infarction.Methods A total of 60 patients with acute myocardial infarction were selected and randomly assigned to control group(n=30)and research group(n=30).The control group received routine treatment,based on which the research group received the combined treatment of emergency coronary intervention.The pre-and post-treatment NT-proBNP levels,left ventricular end-systolic diameter(LVESD)and left ventricular ejection fraction(LVEF),and left ventricular end-diastolic diameter(LVEDD)were compared between the two groups,and the conditions of left ventricular remodeling were observed in the two groups.Results There was a statistically significant difference in level of NT-proBNP(F_(group)=14.453,P_(group)=0.002),the level of NT-proBNP in both groups had a tendency to decrease over time(F_(time)=16.694,P_(time)=0.002),and the grouping interacted with time(F_(interaction)=9.962,P_(interaction)=0.019).Among them,the research group yielded lower level of NT-proBNP after 1,2,3 days of treatment as compared with the control group(all P<0.05).Compared to before treatment,LVESD and LVEDD in both groups more reduced,whereas LVEF more increased at 3 days of treatment,and the research group yielded more significant decrease of LVESD and LVEDD,while more significant increase of LVEF as compared with the control group(all P<0.05).Conclusion Emergency coronary intervention can effectively decrease the levels of NT-proBNP in patients with acute myocardial infarction,improve myocardial function in patients,and inhibit left ventricular remodeling.

关 键 词：急性心肌梗死 急诊冠脉介入治疗 N末端B型利钠肽原 左心室重构 

分 类 号：R542.22[医药卫生—心血管疾病]