急性心肌梗死患者血B-型尿钠肽水平的变化特点

发布时间：2018-04-16 15:35

本文选题：心肌梗塞 + 心钠素　；参考：《中华心血管病杂志》2006年05期

【摘要】：目的观察急性心肌梗死(AMI)后血B-型尿钠肽(BNP)水平升高的特点,探讨AMI后BNP水平升高的意义。方法连续入选住院AMI患者230例及正常对照111例进行BNP测定。按照首次或再发AMI后ST段抬高型或非ST段抬高型AMI(STEMI或NSTEMI)、不同部位AMI、不同冠状动脉病变、不同梗死相关血管(IRA)、IRA不同TIMI血流和是否急诊经皮冠状动脉介入治疗(PCI)进行分组,采用Student-t检验和ANOVA分析对比各组间BNP水平和心功能相关指标的差异。结果AMI后2~7天,患者BNP水平显著升高(P0.01),平均为(553.7±735.1)ng/L,是对照组的21倍;与首次AMI组对比,再发组左室射血分数(LVEF)显著降低(P0.01),左室舒张末径(LVEDd)、BNP水平和LnBNP均显著升高(P均0.01);与无显著狭窄病变AMI患者对比,单支、三支血管狭窄组的BNP水平显著为高(P均0.05);IRA的TIMI血流0~1、2级组BNP水平均显著高于TIMI血流3级组(P均0.01);与未急诊PCI组对比,急诊PCI组血肌酸激酶同工酶(CK-MB)、肌钙蛋白T(TnT)虽显著升高(P0.05~0.01),然BNP水平显著降低(P0.05)。结论AMI后,血BNP水平显著升高。以再发AMI、未行急诊PCI治疗和IRA血流TIMI0~2级者更高。急诊PCI可出现心肌酶升高,而BNP降低的矛盾现象。
[Abstract]:Objective to observe the characteristics of the elevation of serum BNP after acute myocardial infarction (AMI) and to explore the significance of the elevation of BNP after AMI.Methods BNP was measured in 230 consecutive hospitalized AMI patients and 111 normal controls.According to ST-segment elevation or non-ST-elevation AMI(STEMI or NSTEMIA after the first or recurrent AMI, different sites of AMI, different coronary artery lesions, different infarct related vessels, different TIMI blood flow and whether or not emergency percutaneous coronary intervention (PCI) were performed, the patients were divided into two groups.Student-t test and ANOVA analysis were used to compare the difference of BNP level and cardiac function.Results on the 7th day after AMI, the level of BNP increased significantly (P 0.01), with an average of 553.7 卤735.1 ng / L, which was 21 times higher than that of the control group, compared with the first AMI group.In recurrent group, left ventricular ejection fraction (LVEF) decreased significantly (P 0.01), left ventricular end-diastolic diameter (LVED) BNP level and LnBNP increased significantly (P 0.01).The level of BNP in the three vessel stenosis group was significantly higher than that in the TIMI grade 3 group (P < 0.01), and was significantly higher than that in the control group (P < 0.05), which was significantly higher than that in the TIMI group (P < 0.01), and was significantly higher than that in the control group (P < 0.05).In emergency PCI group, serum creatine kinase isoenzyme (CK-MBN) and troponin TnT (TnTc) increased significantly, but BNP level decreased significantly.Conclusion after AMI, the level of serum BNP increased significantly.Patients with recurrent AMI, without emergency PCI treatment and IRA blood flow with TIMI0~2 grade were higher.In emergency PCI, myocardial enzyme increased and BNP decreased.
【作者单位】：
【基金】：首都发展基金资助项目(2002-1029)
【分类号】：R542.22

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