重组人尿激酶原对心肌梗死患者hs-cTnⅠ和NT-proBNP水平的影响  

Effects of recombinant human urokinase on the level of NT-proBNP and hypersensitive myocardial troponin in patients with myocardial infarction

作　　者：陈兰兰 石俊松 李林 郭世荣 刘俊荣 徐锦 钱冬晨 CHEN Lanlan;SHI Junsong;LI Lin(Department of Cardiovascular Medicine,Dongcheng Branch of Jieshou People’s Hospital,Anhui,Jieshou 236500,China)

机构地区：[1]安徽省界首市人民医院东城分院心血管内科一病区,236500 [2]南京中医药大学第二附属医院

出　　处：《河北医药》2022年第18期2797-2800,共4页Hebei Medical Journal

基　　金：南京中医药大学第二附属医院(江苏省第二中医院)院内课题(编号:SEZ202025)。

摘　　要：目的探究重组人尿激酶原对心肌梗死患者超敏心肌肌钙蛋白I(hs-cTnI)、N-末端B型利钠肽原(NT-proNT-proBNP)水平的影响。方法选取2019年4月至2021年10月接受治疗的心肌梗死患者80例为研究对象,依据入院先后顺序分为对照组和研究组。对照组予以尿激酶溶栓治疗,研究组予以重组人尿激酶原治疗。比较2组治疗前后的hs-cTnI、NT-proBNP水平;比较2组治疗前及治疗后7 d的心功能指标变化[左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室射血分数(LVEF)],比较2组患者的血管疏通情况及并发症发生情况,并比较2组治疗后3个月的日常生活能力[日常生活能力评定Barthel指数评估量表和日常生活能力量表(ADL)]。结果治疗后24 h,2组hs-cTnI、NT-proBNP水平均明显低于治疗前,且研究组各指标水平显著低于对照组(P<0.05);治疗后7 d,2组LVEDd、LVESd均低于治疗前,LVEF均高于治疗前,且研究组各指标变化较对照组更显著(P<0.05);研究组的血管疏通情况显著优于对照组(P<0.05),2组并发症发生情况比较差异无统计学意义(P>0.05)。治疗后3个月,研究组的barthel指数评分和ADL评分均明显高于对照组(P<0.05)。结论重组人尿激酶原能有效降低心肌梗死患者的hs-cTnI、NT-proBNP水平,改善患者的心功能,提高血管再通率,且并未明显增加并发症,有助于提高患者的日常生活能力。Objective To investigate the effects of recombinant human urokinase therapy on the levels of hypersensitive cardiac troponin I(hs-cTnI)and N-terminal B-type natriuretic peptide(NT-proBNP)levels in patients with myocardial infarction.Methods A total of 80 patients with myocardial infarction who were treated in our hospital from April 2019 to October 2021 were enrolled in the study,who were divided into control group and research group according to the order of admission,with 40 cases in each group.The patients in control group received urokinase thrombolytic therapy,however,those in research group received recombinant human urokinase progen therapy.The levels of hs-cTnI and NT-proBNP before and after treatment,and the changes of cardiac function indexes before treatment and at 7d after treatment,and the situation of vascular dredging,and the incidence of complications as well as the daily living ability(barthel index and ADL score)at 3 months after treatment were observed and compared between the two groups.Results After 24-hour treatment,the levels of hs-cTnI and NT-proBNP in both groups were significantly decreased,moreover,which in research group were significantly lower than those in control group(P<0.05).At 7d after treatment,the left ventricular end diastolic diameter(LVEDd)and left ventricular end systolic diameter(LVESd)in both groups were decreased,however,the levels of left ventricular ejection fraction(LVEF)were increased,moreover,the decrease degree and increase degree in research group were more significant than those in control group(P<0.05).Moreover the vascular dredging status in research group was superior to that in control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).At 3m after treatment,the barthel Index and ADL(Barthel)scores of daily living in research group were significantly higher than those in control group(P<0.05).Conclusion The recombinant human urokinase therapy can effectively decrease the levels of hs-cTnI and NT-

关 键 词：心肌梗死 重组人尿激酶原 超敏心肌肌钙蛋白 B型利钠肽 N-末端B型利钠肽原 心功能 

分 类 号：R542.2[医药卫生—心血管疾病]