摘要
目的:本研究旨在通过分析急性 ST 段抬高心肌梗死患者基础及经皮冠状动脉介入治疗(PCI)后 B 型利钠肽(BNP)水平,探讨 PCI 治疗对 BNP 水平的影响及 BNP 与近期预后的关系。方法:入选急性 ST 段抬高心肌梗死患者103例,依据入院后治疗方式分为6小时内 PCI 组40例,6～12小时 PCI 组33例,药物治疗组30例。所有患者于入院即刻、发病48小时及7天时从外周静脉中留取血样测定 BNP,分别比较不同时间不同治疗方式之间 BNP 的差别,以及 BNP 与1个月时心功能的关系。所有患者均无心力衰竭、陈旧性心肌梗死及肺部、肾脏疾病史。结果:①3组患者入院即刻基础 BNP 水平无统计学意义(P>0.05)。发病48小时、7天时6小时内 PCI 组 BNP 水平较6～12小时 PCI 组均明显下降,差异均有统计学意义(P<0.05～0.01),6小时内 PCI 组较药物治疗组亦明显下降,差异均有统计学意义(P<0.05～0.01);发病48小时6～12小时 PCI 组 BNP 水平与药物治疗组相比较差异无统计学意义(P>0.05)。发病7天时6～12小时 PCI 组 BNP 水平与药物治疗组比显著下降,差异有统计学意义(P<0.05)。②发病7天时的 BNP 水平与1个月时心功能左心室射血分数有明显相关性(r=-0.722,P<0.001),与 Tei 指数呈正相关(r=0.582,P<0.001)。③随访时发生心力衰竭、心绞痛及心血管事件的患者回顾发病7天时 BNP 水平明显高于未发生者(P<0.05～0.001)。结论:在急性 ST 段抬高心肌梗死患者中,发病7天时 BNP 水平与近期心功能显著相关,对近期心血管事件的发生有一定预测作用,早期 PCI 可以显著降低发病7天时 BNP 水平及降低心血管事件的发生率。
Objective：To evaluate prognosis of patients with ST elevation myocardial infarction（STEMI） by examining B-type natriuretic peptide （BNP） levels after pereutaneous coronary intervention（PCI）. Methods ： A total of 103 eonsecutive patients with STEMI were enrolled. They were divided into 3 groups ： Group 1 （ received PCI within 6 hours from the onset ,n = 40 ） ; Group 2 （ received PCI within 6-12 hours from the onset, n = 33 ） ; Group3 （ received medication, n = 30）. Blood samples for BNP were drawn at admission, 48 hours and 7days from the onset respectively. All patients were followed up at 1 month by eehocardiography. No patients had the history of heart failure, old myoeardial infaretion, lung and kidney disease. Results ：（1）BNP levels were significantly lower at 7 days from the onset in Group 1 and Group 2 than those in Group 3 （204 pg/ml vs 436 pg/ml vs 698 pg/ml, P 〈 0. 05 ）. （2）BNP levels at 7 days from the onset showed a significant negative correlation with LVEF（ r = - 0. 722, P 〈 0. 001 ） and a positive correlation with Tei in 1 month （ r = 0. 582, P 〈 0. 001 ）. （3）By 3 months follow up, BNP levels were significantly increased at 7 days of onset in patients to whom eardiac events happened than not happend（792 pg/inl vs 301 pg/ml, P 〈0. 001 ）. Incidence of heart failure was decreased in Group 1. Conclusion： Elevations in BNP at 7 days from the onset were associated with abnormal LVEF and adverse clinical outcome after STEMI. BNP levels and incidence of cardiac events were decreased in patients received early PCI.
出处
《中国循环杂志》
CSCD
北大核心
2008年第4期271-274,共4页
Chinese Circulation Journal
关键词
B型利钠肽
ST段抬高心肌梗死
经皮冠状动脉介入治疗
B-type natriuretic peptide
ST elevation myocardial infarction
Pereutaneous coronary intervention
