摘要
目的探讨脑钠肽(BNP)、肌红蛋白(Mb)及肌酸激酶同工酶(CK-MB)水平与急性心肌梗死急诊经皮冠状动脉介入术(PCI)术后左室重塑、近期预后的相关性分析。方法选取2019年1月至2021年5月首都医科大学附属北京世纪坛医院收治的急诊行PCI术的急性心肌梗死患者118例设为研究组,再选取同时间收治的96例非PCI治疗急性心肌梗死患者作为对照组。根据研究组患者随访期间预后情况分为预后不良组和预后良好组,对比各组BNP、Mb及CK-MB水平;对比急性心肌梗死患者治疗前后左心室质量指数(LVMI)、左室舒张末期内径(LVEDD),并计算射血分数(LVEF)水平;分析BNP、Mb及CK-MB与急性心肌梗死急诊PCI术后左室重塑的相关性。结果入院时两组BNP、Mb及CK-MB水平比较差异无统计学意义(P>0.05),入院24、72 h,研究组BNP、Mb及CK-MB水平均显著低于对照组(t_(24 h)=77.030、47.928、30.673,P<0.001;t72 h=58.553、55.039、35.442,P<0.001)。经PCI治疗急性心肌梗死患者治疗后LVMI及LVEDD水平低于治疗前、LVEF水平高于治疗前,差异有统计学意义(t=19.500、18.599、11.212,P<0.001)。Spearman相关分析显示,BNP、Mb及CK-MB与急性心肌梗死急诊PCI术后LVMI、LVEDD均呈正相关(P<0.05);BNP、Mb及CK-MB与急性心肌梗死急诊PCI术后LVEF呈负相关(P<0.05)。所有经PCI治疗患者均成功完成随访,随访期间共33例患者预后不良,85例患者预后良好。预后不良组BNP、Mb及CK-MB水平均明显高于预后良好组,差异均有统计学意义(t=45.115、8.811、16.206,P<0.001)。结论BNP、Mb及CK-MB在急性心肌梗死患者中存在异常表达,可能与急性心肌梗死急诊PCI术后左室重塑密切相关,通过检测BNP、Mb及CK-MB水平有助于评估患者近期预后情况。
Objective To investigate the correlation between the levels of brain natriuretic peptide(BNP),myoglobin(Mb)and Creatine kinase-MB(CK-MB)with left ventricular remodeling and short-term prognosis after emergency percutaneous coronary intervention(PCI)in acute myocardial infarction.Methods118 patients with acute myocardial infarction who underwent emergency PCI in Beijing Shijitan Hospital affiliated to Capital Medical University from January 2019 to May 2021 were selected as the study group,and96 patients with acute myocardial infarction without PCI who were treated during the same period were selected as the control group.According to the prognosis of the patients in the study group during the follow-up period,they were divided into the poor prognosis group and the good prognosis group,the levels of BNP,Mb and CKMB in each group were compared.The left ventricular mass index(LVMI),the Left ventricular mass index(LVEDD)before and after treatment in patients with acute myocardial infarction were compared;the level of left ventricular ejection fraction(LVEF)was calculated;and the correlation between BNP,Mb and CK-MB and left ventricular remodeling after emergency PCI in acute myocardial infarction was analyzed.Results There was no difference in the levels of BNP,Mb and CK-MB between the two groups at admission(P>0.05).At 24 and 72 hours after admission,the levels of BNP,Mb and CK-MB in the study group were significantly lower than those in the control group(t_(24 h)=77.030,47.928,30.673,P<0.001;t72 h=58.553,55.039,35.442,P<0.001).The levels of LVMI and LVEDD in patients with acute myocardial infarction treated by PCI were lower than those before treatment,and the level of LVEF was higher than that before treatment,the difference was statistically significant(t=19.500,18.599,11.212,P<0.001).Spearman correlation analysis showed that BNP,Mb and CK-MB were positively correlated with LVMI and LVEDD after acute myocardial infarction after emergency PCI(P<0.05).BNP,Mb and CK-MB were negatively correlated with LVEF after acute myocardial infarction after emergency PCI(P<0.05).All PCI-treated patients completed the follow-up successfully,33 patients had poor prognosis and 85 patients had good prognosis during the follow-up period.The levels of BNP,Mb and CK-MB in the poor prognosis group were significantly higher than those in the good prognosis group,the difference was statistically significant(t=45.115,8.811,16.206,P<0.001).Conclusion BNP,Mb and CK-MB are abnormally expressed in patients with acute myocardial infarction,which may be closely related to left ventricular remodeling after acute myocardial infarction after emergency PCI.Detection of BNP,Mb and CK-MB levels can help to evaluate the short-term prognosis of patients.
作者
杨金月
紫晓
李华丽
杨丽
YANG Jinyue;ZI Xiao;LI Huali;YANG Li(Department of Cardiovascular Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing,China,100038)
出处
《分子诊断与治疗杂志》
2022年第11期1905-1908,1913,共5页
Journal of Molecular Diagnostics and Therapy
基金
北京市自然科学基金面上项目(7182148)。
关键词
BNP
MB
近期预后
CK-MB
急性心肌梗死
左室重塑
BNP
Mb
Short-term prognosis
CK-MB
Acute myocardial infarction
Left ventricular remodeling
