摘要
目的通过比较急性心肌梗死患者急诊经皮冠状动脉介入(PCI)术中再灌注与无复流后脑钠肽前体(NT-proBNP)水平的变化,探讨NT-proBNP与无复流现象发生的相关性。方法选择116例急性心肌梗死行急诊PCI的患者为研究对象。急性心肌梗死患者根据PCI术中TIMI血流分级情况分为再灌注组(79例,TIMI>2级),无复流组(37例,TIMI≤2级)。术前及术后24 h检测NT-proBNP水平,入院即刻及术后1h记录其心电图,计算ST段回降幅度(STR)。结果 (1)再灌注组术前NT-proBNP水平明显低于无复流组(P<0.01);再灌注组术后24 h NT-proBNP水平较术前明显下降(P<0.05);无复流组术后24 h NT-proBNP水平较术前无明显变化(P>0.05);再灌注组术后24 h NT-proBNP水平较无复流组明显下降(P<0.01)。(2)再灌注组ST段迅速回落者所占百分比明显高于无复流组(P<0.01);(3)无复流组30 d内心血管事件的发生率显著高于再灌注组(P<0.01)。结论 NT-proBNP水平升高是心肌组织灌注不足的体现,可较好的预测无复流现象的发生;心电图ST段回降幅度可作为灌注不良的指标之一;无复流增加30 d内心血管事件的再发生率。
Objective To explore the relationship between serum NT-proBNP （NT-pro brain natriuretic peptide） and no-re- flow in patients with acute myocardial infarction, by comparing changes in the levels of NT-proBNP between the reperfusion group and the no-reflow group. Methods One hundred and sixteen patients （ aged 59.3 ± 17.2 years） with acute myocardial infarction undergo- ing emergent percutaneous coronary intervention were chosen as research subjects. In accordance with Thrombolysis In Myocardial In- farction （TIMI） blood flow grading method, the patients with acute myocardial infarction were divided into the reperfusion group （79 ca- ses, TIMI 〉 grade 2） and the no-reflow group（37 cases, TIMI ≤ grade 2）. Levels of NT-proBNP were detected 24 hours before and after admission into the hospital. ECG was monitored the moment before admission and 1 hour after PCI, and then ST-segment resolution （STR） was calculated. Differences in the above data were compared between the reperfusion group and the no-reflow group to see if there was statistical significance. Results （ 1 ） The level of serum NT-proBNP in the reperfusion group was significantly lower than that of the no-reflow group, with statistical significanee（P 〈0.01 ）. The level of serum NT-proBNP in the reperfusion group was obviously lower than that before PCI（P 〈0.05）. No significant changes could be noted in the level of NT-proBNP 24 hours after PCI for the no- reflow group（ P 〈 0.05 ）. The level of NT-proBNP in the reperfusion group 24 hours after PCI was not significantly decreased, as com- pared with that of the no-reflow group, with statistical significance （ P 〈 0, 01 ）. （2） The percentage of STR for the reperfusion group wasobviously higher than that of the no-reflow group, also with statistical significance （P 〈 0.01 ）. （3）Incidence of cardiovascular events within one month for the no-reflow group was significantly higher than that of the reperfusion group, and statistical significance could be noted, when comparisons were made between them（ P 〈 0.01 ）. Conclusion NT-proBNP was a manifestation of insufficient myocardi- um perfusion, which could well predict the occurrence of no-reflow. STR could be used as one of the indexes of poor perfusion, and no- reflow could increase the incidence of cardiovascular events within 1 month.
出处
《海军医学杂志》
2014年第2期99-100,103,共3页
Journal of Navy Medicine
基金
临沂市科技局立项课题(201313031)
关键词
脑钠肽前体
无复流
急性心肌梗死
经皮冠状动脉介入
NT-pro brain natriuretic peptide
No-reflow
Acute myocardial infarction
Percutaneous coronary intervention
