【摘要】 目的观察急性心肌梗死(AMI)患者血浆中B型钠尿肽(BNP)、D-二聚体(D-D)、纤维蛋白原(Fib)水平变化,为诊断、治疗及预后判断提供依据。方法应用快速免疫荧光法分别测定对29例AMI患者治疗前后和29名正常对照者血浆中BNP水平进行检测,通过血凝仪进行D-D、Fib测定,D-D采用免疫比浊法,Fib采用凝固法。结果AMI患者血浆中BNP、D-D、Fib治疗前后比较差异有显著性(Fib:P<0.05,D-D:P<0.05,BNP:P<0.01),正常对照组与AMI治疗前比较差异有显著性(Fib:P<0.01,D-D:P<0.01,BNP:P<0.01),BNP与D-D在AMI治疗前水平呈正相关(r=0.825),治疗后呈明显的下降趋势(r=0.507),AMI经溶栓和相应的支持治疗后Fib基本恢复到正常水平(P>0.05),而BNP、D-D水平虽然下降明显,但与正常组比较差异仍有显著性(BNP:P<0.01,D-D:P<0.01)。结论AMI患者血浆中BNP、D-D、Fib水平的变化说明其参与了AMI的发生、发展,特别是冠状动脉粥样斑块的形成和(或)破裂及血栓形成。因此BNP、D-D、Fib等3项指标的观察分析对AMI诊断、治疗和预后判断具有重要意义。更多还原

【Abstract】 Aim To explore the pathogenesis and provide evidence for the diagnosis,therapy and prognosis of acute myocardial infarction(AMI) by observing the levels of B-type natriuretic peptide(BNP),D-Dimer(D-D) and fibrinogen(Fib) in plasma of the patients.Methods BNP level in the plasma of 29 AMI patients before and after treatment and 29 normal controls were detected by rapid fluorescence immunoassay.The D-Dimer was determined by immune turbidimetry and the fibrinogen(Fib) was determined by coagulation method with the coagulation detector.Results There were significant differences between the patients with AMI before and after treatment in the levels of BNP,D-D and Fib(Fib:P< 0.05,D-D:P< 0.05,BNP:P< 0.01),and differences also in AMI group and control group(Fib:P<0.01,D-D:P<0.01,BNP:P< 0.01).There were positive correlation between BNP and D-D before treatment(r= 0.825) and after treatment(r= 0.507).The Fib level recovered to normal(P>0.05) after thrombolysis and other supporting therapy.The decreased BNP and D-D were significantly higher than those in control groups(BNP:P< 0.01,D-D:P< 0.01).Conclusions The changes of BNP,D-D and Fib indicate that they are involved in the occurrence and development of AMI,especially in the formation and disruption of atheromatous plaque and thrombosis.So the determination of BNP,D-D and Fib levels are significant to the diagnosis,treatment and prognosis.更多还原