急性心肌梗死患者急诊经皮冠状动脉介入术后泵衰竭早期应用重组人脑利钠肽的临床效果  

Clinical Effect of Early Application of Recombinant Human Brain Natriuretic Peptide in Patients with Acute Myocardial Infarction After Emergency Percutaneous Coronary Intervention for Pump Failure

作　　者：赵金芝 李文娟 陶功达 张宛 ZHAO Jinzhi;LI Wenjuan;TAO Gongda;ZHANG Wan(Emergency Department,Nanyang Nanshai Hospital,Nanyang 473000,China)

机构地区：[1]南阳南石医院急诊科,河南南阳473000

出　　处：《河南医学研究》2023年第10期1854-1857,共4页Henan Medical Research

摘　　要：目的 探究对急性心肌梗死(AMI)患者急诊经皮冠状动脉介入(PCI)术后泵衰竭早期应用重组人脑利钠肽(rh-BNP)的临床效果。方法 选取南阳南石医院2020年1月至2022年6月收入并确诊AMI患者96例,均接受时间窗内急诊PCI,术后72 h内发生泵衰竭,依据随机数表法将其分为对照组和观察组,各48例。对照组接受常规药物治疗,观察组接受rh-BNP,常规随访6个月。比较两组住院期间及院后随访期间主要心脏不良事件(MACEs)的发生率,治疗前和治疗7 d后血清BNP和肌钙蛋白(cTnI)、中性粒细胞与淋巴细胞比值(NLR)、高敏C反应蛋白(hs-CRP)和脂蛋白相关磷脂酶A_(2)(Lp-PLA_(2))水平,左室射血分数(LVEF)和左室舒张末容积(LVEDV)以及心肌梗死溶栓治疗(TIMI)风险评分。结果 对照组45例和观察组46例患者临床至随访研究结束,观察组随访期间MACEs的发生率低于对照组(P<0.05)。两组治疗后BNP和cTnI、NLR、hs-CRP和Lp-PLA_(2)水平较治疗前降低,且观察组低于对照组(P<0.05)。两组治疗后LVEF比治疗前升高,TIMI风险评分降低,且观察组LVEF高于对照组,TIMI风险评分低于对照组(P<0.05)。结论 针对AMI患者急诊PCI术后泵衰竭早期应用rh-BNP有较好的短期临床预后,对改善BNP和cTnI水平、减轻炎症反应、提高LVEF以及降低TIMI风险评分有较好的应用价值。Objective To explore the clinical effect of early application of recombinant human brain natriuretic peptide(rh-BNP)in patients with acute myocardial infarction(AMI)after emergency percutaneous coronary intervention(PCI)for pump failure.Methods From January 2020 to June 2022,96 patients with AMI who were admitted and diagnosed in Nanyang Nanshai Hospital were selected,all of whom underwent emergency PCI within a time window.Pump failure occurred within 72 hours after surgery.They were divided into control group and observation group based on the random number table method,with 48 patients in each group.The control group was treated with conventional drugs,while the observation group was treated with rh-BNP,with a regular follow-up of 6 months.The incidence of major adverse cardiac events(MACEs),serum BNP and cardiac troponin I(cTnI),neutrophil to lymphocyte ratio(NLR),high sensitivity C-reactive protein(hs-CRP),and lipoprotein associated phospholipase A 2(Lp-PLA 2)levels,left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),and thrombolysis in myocardial infarction(TIMI)risk score were compared between the two groups during hospitalization and post hospital follow-up.Results Forty-five patients in control group and 46 patients in observation group were followed up to the end.The incidence of maces in observation group during hospitalization and follow-up was lower than that in control group(P<0.05).After treatment,the levels of BNP,cTnI,NLR,hs-CRP and Lp-PLA 2 in the two groups were less than before,and they in observation group were lower than those in control group(P<0.05).After treatment,LVEF increased and TIMI risk score decreased in the two groups,and LVEF in observation group was higher than that in control group,and TIMI risk score was lower than that in control group,too(P<0.05).Conclusion Early application of rh-BNP in patients with AMI with pump failure after emergency PCI has a good short-term clinical prognosis,and has good application value in improving BNP and cTnI le

关 键 词：急性心肌梗死 经皮冠状动脉介入 泵衰竭 重组人脑利钠肽 

分 类 号：R541.4[医药卫生—心血管疾病]