老年急性前壁心肌梗死患者急诊经皮冠状动脉介入术前主动脉内球囊反搏联合术后重组人脑利钠肽对心室重构的影响  

Effect of intra-aortic balloon counterpulsation combined with rhBNP on ventricular remodeling in elderly patients with acute anterior myocardial infarction before emergency PCI

作　　者：李圣博 冯玲 陈贝贝 姚芳 邢永生[1] 刘艳宾[1,3] LI Shengbo;FENG Ling;CHEN Beibei;YAO Fang;XING Yongsheng;LIU Yanbin(Cardiovascular Intensive Care Unit of Xinxiang Central Hospi-tal,Xinxiang 453000,Henan,China;不详)

机构地区：[1]新乡市中心医院心血管重症监护病房,河南新乡453000 [2]新乡市中心医院检验科,河南新乡453000 [3]新乡市体外生命支持工程技术研究中心,河南新乡453000

出　　处：《实用医学杂志》2025年第5期699-703,共5页The Journal of Practical Medicine

基　　金：河南省科技攻关(指导立项)(编号:232102310257)。

摘　　要：目的分析主动脉内球囊反搏联合重组人脑利钠肽(rhBNP)治疗对急性前壁心肌梗死老年患者经皮冠状动脉介入术(PCI)术后心室重构的影响。方法回顾性分析于2018年1月至2023年6月我院收治行急诊PCI的急性前壁心肌梗死老年患者66例,分为两组。对照组(n=32)进行PCI术+rhBNP,研究组(n=34)PCI术+rhBNP+主动脉内球囊反搏。检测对比两组血压、乳酸水平及机械并发症、心室重构、炎性因子、心肌酶学、ox-LDL水平。结果治疗前,对比两组乳酸、舒张压、收缩压、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室后壁厚度(LVPWT)、左心室重构指数(LVRI)、左室射血分数(LVEF)、同型半胱氨酸(Hcy)、白细胞介素-6(IL-6)、肌钙蛋白T(cTnT)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、氧化性低密度脂蛋白(ox-LDL)水平(P>0.05);出院后3个月随访,乳酸、LVESD、LVEDD、LVPWT、LVRI、Hcy、IL-6、c TnT、LDH、CK-MB、ox-LDL水平降低,且研究组较低,舒张压、收缩压、LVEF水平上升,且研究组较高(P<0.05)。治疗前后两组机械并发症占比对比差异无统计学意义(P>0.05)。结论急性前壁心肌梗死老年患者急诊PCI术后采用主动脉内球囊反搏联合rhBNP治疗,可缓解患者心室重构、心肌损伤,减轻炎性损伤,改善氧化应激反应,调节组织灌注。Objective The effect of intra‑aortic balloon counterpulsation combined with recombinant human brain natriuretic peptide(rhBNP)treatment on ventricular remodeling after percutaneous coronary intervention(PCI)in elderly patients with acute anterior wall myocardial infarction.Methods A retrospective analysis was conducted on 66 elderly patients with acute anterior myocardial infarction who underwent emergency PCI in our hospital from January 2018 to June 2023.They were divided into a control group(n=32)who underwent PCI+rhBNP,and a study group(n=32)who underwent PCI+rhBNP+intra‑aortic balloon counterpulsation.Blood pressure,lactic acid level,mechanical complications,ventricular remodeling,inflammatory factors,myocardial enzymology,ox‑LDL level were detected and compared between the two groups.Results Before treatment,Lactic acid,diastolic blood pressure,systolic blood pressure,left ventricular end‑systolic diameter(LVESD),left ventricular end‑diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPWT),left ventricular remodeling index(LVRI),left ventricular ejection fraction(LVEF),homocysteine(Hcy),interleukin‑6(IL‑6)and myocardial troponin were compared between the two groups.Myocardial troponin T(cTnT),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK‑MB),oxidized low density lipoprotein(ox‑LDL)levels(P>0.05);At 3 months follow‑up after discharge,the levels of lactic acid,LVESD,LVEDD,LVPWT,LVRI,Hcy,IL‑6,cTnT,LDH,CK‑MB and ox‑LDL were decreased,and the levels were lower in the study group,and the levels of diastolic blood pressure,systolic blood pressure and LVEF were increased,and the levels were higher in the study group(P<0.05).The proportion of mechanical complications between the two groups before and after treatment were compared(P>0.05).Conclusion In elderly patients with acute anterior myocardial infarction after emergency PCI,intra‑aortic balloon counterpulsation combined with rhBNP could alleviate ventricular remodeling,myocardial injury,reduce inflammatory

关 键 词：主动脉内球囊反搏 重组人脑利钠肽 急性前壁心肌梗死 经皮冠状动脉介入术 心室重构 

分 类 号：R542.2[医药卫生—心血管疾病]