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|本期目录/Table of Contents|

经皮冠状动脉介入治疗对急性心肌梗死患者氨基末端脑钠尿肽原及心功能的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第4期
页码:
461-463，467
栏目:
临床研究
出版日期:
2012-08-25

文章信息/Info

Title:
Effects of percutaneous coronary intervention on level of N-terminal pro-brain natriuretic peptide and heart function in patients with acute myocardial infarction
作者:
刘向阳; 唐良秋; 江志平; 张社兵; 李爱华; 万槐斌; 范文茂
(汕头大学附属粤北人民医院心血管内科，广东 韶关 512026)
Author(s):
LIU Xiang-yang;  TANG Liang-qiu;  JIANG Zhi-ping;  ZHANG She-Bing;  LI Ai-hua;  WAN Huai-bin;  FAN Wen-mao
(Department of Cardiology, Affiliated Yuebei Hospital, Shantou University, Shaoguan 512026, Guangdong, China)
关键词:
心肌梗死; 急性; 经皮冠状动脉介入治疗; 氨基末端脑钠肽原; 心功能
Keywords:
acute myocardial infarction;  percutaneous coronary intervention;  N-terminal pro-brain natriuretic peptide;  heart function
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:研究急性心肌梗死(AMI)患者接受急诊及择期经皮冠状动脉介入治疗（PCI）后血浆氨基末端脑钠尿肽原（NT-proBNP）水平变化及其与心功能的关系。方法： 入选2009年7月~2010年12月，发病后12 h内接受急诊PCI治疗的ST段抬高型心肌梗死（STEMI）患者94例，住院期间未行第2次PCI治疗者为A组（n=46），住院期间第5~7天行第2次PCI治疗者为B组（n=48）；发病后24 h内入院的AMI患者未行再灌注治疗者为C组（n=34）；使用电化学发光测量不同时间NT-proBNP水平，同时测量心肌梗死后不同时间左室舒张末期直径(LVEDD)、左室收缩末期容积(LVSDV)、左室舒张末期容积(LVEDV)及左室射血分数(LVEF)。结果： A、B两组各时间点NT-proBNP水平较C组明显下降，LVEDD、LVSDV、LVEDV、LVEF在45 d及6个月时较C组明显下降，差异有统计学意义（P<0.05）；同时，B组NT-proBNP水平在45 d及6个月时与A组相比进一步下降，LVEDD、LVSDV、LVEDV、LVEF测量值则进一步改善，两组差异也有统计学意义（P<0.05）。结论： STEMI患者行PCI后NT-proBNP水平有显著下降趋势，且NT-proBNP水平可以作为患者心功能预测因子，后续的择期PCI治疗能进一步降低NT-proBNP及改善心功能。
Abstract:
AIM:To investigate the effects of percutaneous coronary intervention (PCI) on the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and the heart function in patients with acute myocardial infarction (AMI). METHODS: One hundred and twenty-eight patients with AMI were divided into group A of primary PCI (n=46), group B of primary and selective PCI (n=48) and group C of conventional treatment (n=34). Plasma NT-proBNP was measured by electrochemiluminescence in these patients immediately, 24 h, 5 days, 11 days, 45 days and 6 months after admission. Patients underwent ultrasound electrocardiogram examination at the 12th-15th day, 45th day and 6th month. RESULTS: NT-proBNP levels after PCI in group A and group B were significantly lower and heart function was better than those in group C (P<0.05). NT-proBNP levels of group B were lower than those in group A at the 45th day and 6th month (P<0.05). The results of ultrasound electrocardiogram at the 45th day and 6th month showed a significant difference in left ventricular end-diastolic diameter (LVDd), left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) between group A and group B (P<0.05), whereas no significant difference was seen at the 12th -15th day. CONCLUSION: NT-proBNP level in patients with AMI declines after PCI and can be used as a predictor of cardiac function and ventricular remodeling. Subsequent elective PCI treatment may further reduce the NT-proBNP level and improve heart function.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2011-12-26.基金项目：广东省韶关市医药卫生科研计划项目资助（Y10022） 作者简介：刘向阳，主治医师，硕士Email:longliu0714@sina.com
更新日期/Last Update: 2012-07-20