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Title:: Relationship between plasma levels of brain natriuretic peptide and cardiac function in patients with acute myocardial infarction

作者:: 王艳¹; 2; 薛燕³; 王东娟¹; 郝媛媛¹; 李飞¹; 司瑞¹; 郭文怡¹; (1.第四军医大学西京医院心内科，陕西西安 710032；2.蒲城县医院心内科，陕西蒲城 715500；3.西安市东方医院心内科，陕西西安 710043)

Author(s):: WANG Yan¹; 2; XUE Yan³; WANG Dong juan¹; HAO Yuan yuan¹; LI Fei¹; SI Rui¹; GUO Wen yi¹; (1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China; 2.Department of Cardiology, Pucheng Hospital, Pucheng 715500, Shaanxi, China; 3.Department of Cardiology, Xi’an Oriental Hospital, Xi’an 710043, Shaanxi, China)

关键词:: 心肌梗死; 急性; 脑尿钠肽; 左心室射血分数; 心功能分级

Keywords:: acute myocardial infarction; brain natriuretic peptide; left ventricular ejection fraction; Killip classification

分类号:: R541.4

DOI:: -

文献标识码:: A

摘要:: 目的:探讨急性心肌梗死(AMI)患者血浆脑钠尿肽(BNP)与左心室射血分数(LVEF)、左心室舒张末容积(LVEDV)、Killip分级及心肌梗死部位的关系，评价BNP对AMI患者心功能和危险分层的预测价值。方法:检测120例AMI患者和120例对照组血浆BNP水平，同时行心脏彩色多普勒检测LVEF、LVEDV，比较AMI组与对照组以及不同LVEF、Killip分级和不同梗死部位亚组间的血浆BNP水平差异。结果:与对照组相比，AMI组BNP和LVEDV显著升高，LVEF显著降低 (均P<0.01)。与LVEF>50%组比较，LVEF<40%组BNP、LVEDV显著升高(P<0.05)；与Killip I、II级比较，Killip III、IV级组BNP显著升高(P<0.05)，Killip IV级组LVEDV显著增大(P<0.05)。与下壁心肌梗死患者相比，下后壁、前壁梗死患者BNP显著升高(P<0.05)。BNP与Killip分级成正相关(r=0.97，P<0.05)，与LVEF成负相关(r=-0.33，P<0.05)。结论:AMI患者血浆BNP显著增高，尤以LVEF<40%、Killip IV级、前壁心肌梗死者为甚。

Abstract:: AIM:To explore the relationship between plasma brain natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF), left ventricular diastolic volume (LVEDV), and Killip classification and to evaluate the predictive value of BNP in patients with acute myocardial infarction (AMI). METHODS: A total of 120 AMI patients and 120 control subjects were investigated by measuring plasma BNP levels using MEIA. LVEF and LVEDV were assessed using echocardiography. RESULTS: Plasma BNP levels and LVEDV in AMI groups were significantly higher than those in control group, however, LVEF was significantly lower than that in control group (P<0.01). Plasma BNP levels and LVEDV in LVEF<40% group were higher than those in LVEF>50% group (P<0.05). BNP levels in Killip III, Ⅳ group were also significantly higher than those in KillipⅠ,Ⅱ group (P<0.05). Compared with those in patients with inferior myocardial infarction, BNP levels were significantly higher in patients with anterior myocardial infarction and inferiorposterior myocardial infarction (P<0.05). There were a positive correlation between BNP levels and the Killip classification (r=0.97, P=0.029), but a negative correlation between BNP levels and LVEF (r=-0.33, P=0.0036). CONCLUSION: Plasma BNP levels are significantly increased in AMI patients, especially in patients with LVEF<40%, Killip Ⅳ or extensive anterior myocardial infarction. BNP indicates the severity of myocardial infarction, which may be an important predictor for left ventricular dysfunction.

参考文献/References

[1]陆再英,钟南山.内科学[M].第7版.北京:人民卫生出版社,2012:284-297.
[2]Mc Cullough PA,Omland T,Maisel AS,et al.B-type natriuretic peptides:a diagnostic breakthrough for clinicians[J].Rew Cardiovasc Med,2002,4(2):72-76.
[3]Feola M,Valeri L,Menditto E,et al.Comparison between immunoradiometric and fluorimetric brain natriuretic peptide determination in patients with congestive heart failure[J].J Endocrinol Invest,2010,33(8):554-558.
[4]CohenSolal A,Logeart D,Huang B,et al.Lowered B type natriuretic peptide in response to levosimendan or dobutamine treatment is associated with improved survival in patients with severe acutely decompensated heart failure[J].J Am Coll Cardiol,2009,53(25):2349-2352.
[5]Kaneshiro T,Suzuki H,Yamada S,et al.Intrathoracic impedance changes reflect reverse left ventricular remodeling in response to cardiac resynchronization therapy in chronic heart failure patients[J].Int Heart J,2012,53(4):249-252.
[6]Vitlianova KD,Donova TI,Apostolova MD.Predictive factors for high brain(B-type)natriuretic peptide at discharge in properly treated heart failure patients[J].Folia Med (Plovdiv),2011,53(1):19-27.
[7]Krum H,Jelinek MV,Stewart S,et al.2011 update to National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand Guidelines for the prevention,detection and management of chronic heart failure in Australia,2006[J].Med J Aust,2011, 194(8):405-409.
[8]DurakNalbantic A, Dubur A, Dilic M, et al. Brain natriuretic peptide release in acute myocardial infarction[J].Bosn J Basic Med Sci,2012,12(3):164-168.
[9]Wiezorek SJ,Wu AH,Christensen R,et al.A rapid B-type natriuretic Peptide assay accurately diagnoses left ventricular dysfunction and heart failure:a multicenter evaluation[J].Am Heart J,2002,144(5):834-839.
[10]tambuk K,Bulj N,Trbuic M,et al.B-type natriuretic peptide as predictor of heart failure in patients with acute ST elevation myocardial infarction, singlevessel disease, and complete revascularization:followup study[J].New Croat Med J,2009,50(5):449-454.

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急性心肌梗死患者血浆脑尿钠肽与心功能的相关性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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