重组人脑利钠肽对急性右心室并前壁心肌梗死PCI术后血流动力学及心室重塑的影响  

Effect of recombinant human brain natriuretic peptide on hemodynamics and ventricular remodeling after pci in patients with acute right ventricular and anterior myocardial infarction

作　　者：邓少雄 黄文森 洪美满[2] Deng Shao-xiong;Huang Wen-sen;Hong Mei-man(Medical Department of Quanzhou Medical College,Quanzhou 362000,Fujian,China;Department of Heart Internal Medicine,The Affiliated the First Hospital of Quanzhou,Fujian Medical University,Quanzhou 362000,Fujian,China)

机构地区：[1]福建省泉州医学高等专科学校临床医学院内科教研室,福建泉州362000 [2]福建医科大学附属泉州第一医院,福建泉州362000

出　　处：《四川生理科学杂志》2023年第7期1137-1140,共4页Sichuan Journal of Physiological Sciences

基　　金：泉州市指导性科技计划项目(编号:Z[2013]0119);。

摘　　要：目的:探讨重组人脑利钠肽(Recombinant human brain natriuretic peptide,rhBNP)对急性右心室并前壁心肌梗死经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术后血流动力学及心室重塑的影响。方法:急性右心室并前壁心肌梗死患者122例于直接PCI术后随机分为常规治疗组(n=65)和rhBNP组(n=57)。观察两组患者治疗前后血流动力学的变化和心脏超声心动图的检查结果。结果:与治疗前相比,rhBNP组患者在治疗后肺毛细血管契压(Pulmonary capillary wedge pressure,PCWP)及右心房压下降、心脏指数(Cardiac index,CI)升高(P<0.05);与常规治疗组相比,rhBNP组治疗后的PCWP、右心房压降低,CI升高,且差异均有统计学意义(P<0.001)。与治疗前相比,rhBNP组患者在治疗后左心室收缩末期内径(Left ventricular end-systolic diameter,LVIDs)及左心室舒张末期内径(Left ventricular end-diastolic diameter,LVIDD)均降低,而左心室射血分数(Left ventricular ejection fraction,LVEF)升高(P<0.001);与常规治疗组相比,rhBNP组治疗后的LVIDs及LVIDd降低,LVEF升高,且差异均有统计学意义(P<0.001)。结论:急性右心室并前壁心肌梗死直接PCI术后应用rhBNP可以改善患者的血流动力学变化及心室重塑。Objective:To further investigate the effects of recombinant human brain natriuretic peptide(rhBNP)on hemodynamics and ventricular remodeling after percutaneous coronary intervention(PCI)in patients with acute right ventricular and anterior myocardial infarction.Methods:Total of 122 patients with acute right ventricle and anterior myocardial infarction were randomly divided into two groups:routine treatment group(n=65)and rhBNP group(n=57)after direct PCI.The hemodynamic changes and the results of cardiac echocardiography before and after treatment between the two groups were compared.Results:Significant differences were found in the decreasing of pulmonary capillary wedge pressure(PCWP),right atrial pressure and the increasing of cardiac index(CI)(P 0.05)in both groups after treatment.Between the routine treatment group and the rhBNP group,significant differences were found in the decreasing of PCWP,right atrial pressure and the increasing of CI(P<0.001)after treatment.In the rhBNP group,the left ventricular end-systolic diameter(LVIDs)and left ventricular end-diastolic diameter(LVIDd)decreased after treatment,and the left ventricular ejection fraction(LVEF)increased after treatment(P<0.001).Significantly difference was found in the decreasing of LVIDs,LVIDd and the increasing of LVEF compared with the routine treatment group after treatment(P<0.001).Conclusion:RhBNP can improve hemodynamics and ventricular remodeling in patients with acute right ventricle and anterior wall myocardial infarction after PCI.

关 键 词：重组人脑利钠肽 心肌梗死 经皮冠状动脉介入治疗 血流动力学 心室重塑 

分 类 号：R542.22[医药卫生—心血管疾病]