急性心肌梗死患者急诊冠脉介入术后 BNP 的应用研究

医学研究与教育 ›› 2015, Vol. 32 ›› Issue (2): 24-29.

急性心肌梗死患者急诊冠脉介入术后 BNP 的应用研究

田智羽¹，赵文萍²，贾新未²，许晶晶¹，潘焕军²，李雅²，赵淑君²

1. 河北大学，河北保定 071000；2. 河北大学附属医院心内科1，河北保定 071000

出版日期:2015-04-25 发布日期:2015-04-25
通讯作者: 赵文萍（1968—），女，河北保定人，主任医师，博士，硕士生导师，主要从事心血管疾病的诊断和治疗。E-mail: heartfailure1@sina.com
作者简介:田智羽（1986—），男，河北易县人，在读硕士。 E-mail: zhiyu1006@163.com

Application research on BNP in acute myocardial infarction patients with primary percutaneous coronary intervention

TIAN Zhiyu¹, ZHAO Wenping²,JIA Xinwei², XU Jingjing¹, PAN Huanjun², LI Ya², ZHAO Shujun²

1. Hebei University, Baoding 071000, China; 2. No.1 Department of Cardiovascular Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China

Online:2015-04-25 Published:2015-04-25

摘要/Abstract

摘要： 目的分析急性 ST 段抬高型心肌梗死（ST segment elevtion myocardical infarction，STEMI）患者血浆 B- 型钠尿肽（B-type natriuretic peptide，BNP）水平与左室室壁运动积分指数（left ventrcular wall motion score index，LVWMSI）之间的关系，并观察不同 BNP 水平患者 180 d 内预后情况。方法收集首次发生的 STEMI 患者 64 例，均于发病 12 h 内急诊行冠状动脉介入治疗。依据 BNP 水平由低到高将所有研究对象分为 4 组（按 4 个百分位数）：A 组（BNP≤P25: BNP≤115.25 pg/mL）、B 组（P26≤BNP≤P50: 115.26～200.5 pg/mL）、C 组（P51≤BNP≤P75: 200.6～409 pg/mL）、D组（BNP≥P76: BNP≥409 pg/mL）。分析各组间 LVWMSI 的关系以及 BNP水平与 LVWMSI 的相关关系。随访记录 180 d 内主要心血管不良事件（major adverse cardiac events，MACE）发生情况，并分析其与血浆 BNP 水平的关系。结果各组间LVWMSI 比较差异均有统计学意义（P<0.05），BNP 水平与 LVWMSI 呈正相关（r=0.73，P<0.01）。随血浆 BNP 水平增高，各组间近期临床心血管事件呈显著增高趋势（P<0.05）。结论血浆 BNP 水平能够反应急性心肌梗死患者心功能变化，预测近期预后。

关键词: B- 型钠尿肽, 室壁运动积分指数, 急性心肌梗死, 急诊 PCI, 主要心血管不良事件

Abstract: Objective To investigate the relationship between plasma Brain natriuretic peptide(BNP) level and left ventricular wall motion score index (LVWMSI) in patients with acute ST-segment elevation myocardial infarction (STEMI), and the short term prognosis within 180 days. Methods Sixty four patients with STEMI were treated with primary percutaneous coronary intervention (p-PCI) within 12 h of onset. The BNP level was measured on admission. Based on the BNP level, all patients were divided into four groups (according to the 4 percentile): group A (BNP≤P25: BNP≤115.25 pg/mL), group B(P26≤BNP≤P50: 115.26-200.5 pg/mL), group C(P51≤BNP≤P75: 200.6 -409 pg/mL)and group D(BNP≥P76: BNP≥409 pg/mL). The relationship of BNP level with LVWMSI was analysised. The major adverse cardiac events (MACE) within 180 days were also analyzed. Results The difference of left ventricular wall motion score index among different groups were statistical significant (P<0.05). The levels of BNP and LVWMSI was positively related(r=0.73, P<0.01).Along with the increase of plasma BNP level, major adverse cardiac events increased significantly (P<0.05). Conclusion Plasma BNP level provides information about the change of heart function and short term prognosis for acute myocardial infarction patients.

Key words: B-type natriuretic peptide, left ventricular wall motion score index, acute ST-segment elevation myocardial infarction, primary percutaneous coronary intervention, major adverse cardiac events

中图分类号:

田智羽，赵文萍，贾新未，许晶晶，潘焕军，李雅，赵淑君. 急性心肌梗死患者急诊冠脉介入术后 BNP 的应用研究[J]. 医学研究与教育, 2015, 32(2): 24-29.

TIAN Zhiyu, ZHAO Wenping, JIA Xinwei, XU Jingjing, PAN Huanjun, LI Ya, ZHAO Shujun. Application research on BNP in acute myocardial infarction patients with primary percutaneous coronary intervention[J]. Medical Reserch and Education, 2015, 32(2): 24-29.

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