【摘要】 目的:研究静脉应用重组人B-型利钠肽(rhBNP)对急性心肌梗死冠状动脉(冠脉)介入术后患者心室重塑和收缩同步性的影响。方法:选择48例12小时内发病的急性前壁心肌梗死冠脉介入术后患者,随机分为rhBNP组25例和常规治疗组23例,分别于治疗后1周、4周和24周采用二维超声心动图测定舒张末期容积指数、收缩末期容积指数、左心室射血分数、左心室质量指数,梗死区的局部室壁运动指数。于治疗后1周、24周时行平衡法核素心室造影,了解心室收缩同步性参数。结果:①治疗后1周时,rhBNP组左心室收缩末期容积指数较常规治疗组降低、左心室射血分数较常规治疗组升高(P<0.05)。治疗后4周、24周时,rhBNP组左心室舒张末期容积指数、左心室收缩末期容积指数、左心室射血分数较常规治疗组差异均有统计学意义。治疗后24周时,rhBNP组的左心室质量指数,梗死区的局部室壁运动指数较常规治疗组明显下降,差异均有统计学意义(P<0.05)。②治疗后1周时心室相角程、半高宽、峰相位标准差在两组患者间差异无统计学意义(P>0.05),治疗后24周时rhBNP组上述3项指标较常规治疗组差异有统计学意义(P<0.05)。结论:冠脉介入术后在常规治疗的基础上应用rhBNP可进一步阻抑急性前壁心肌梗死后心室重塑,提高心室收缩同步性,改善左心功能。更多还原

【Abstract】 Objective: To evaluate the influence of recombinant human brain natriuretic peptide(rhBNP)on ventricular remodeling and ventricular systolic synchrony in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI).Methods: A total of 48 patients with AMI after PCI were randomized into two groups: rhBNP Group(n=25) and Routine treatment Group(n=23).Two dimension echocardiography was used to measure the index of left ventricular end-diastolic volume(LVEDVI),the index of left ventricular end-systolic volume(LVESVI),left ventricular ejection fraction(LVEF),the index of left ventricular mass(LVMI),the movement index of infarcted regional wall(RWMI) at 1 week,4 weeks and 24 weeks after the treatment procedure.And at 1 week and 24 weeks period,equilibrium radionuclide angiography was performed respectively to evaluate the ventricular systolic synchrony.Results: ① 1 week after PCI,LVESVI in rhBNP group was decreased and LVEF was increased than that in Routine treatment group(P<0.05,respectively).4 and 24 weeks after PCI,LVEDVI,LVESVI,LVEF were significantly different in rhBNP group than those in Routine treatment group(P<0.05,respectively).24 weeks after PCI,RWMI and LVMI were significantly decreased in rhBNP group than those in Routine treatment group(P<0.05,respectively).②24 weeks after PCI,phase shift,full width at half maximum and peak phase standard deviation were significantly improved in rhBNP group than those in Routine treatment group(P<0.05,respectively).Conclusion: Intravenous injection of rhBNP could inhibit left ventricular remodeling and improve left ventricular function.更多还原