【摘要】 目的探讨急诊冠状动脉介入(p-PCI)术后应用重组人脑钠肽(rhBNP)对急性心肌梗死患者心室重构的影响。方法 83例急性ST段抬高型心肌梗死患者于发病12 h内接受p-PCI,其中对照组44例术后给予常规治疗,治疗组39例术后常规治疗加静脉注射rhBNP。术前检测两组患者血浆人脑钠肽(BNP)水平;术后24 h内及6个月行超声心动图检测,测定左室射血分数(LVEF)、左心室舒张末期容积(LVEDV);记录术后6个月内不良心血管事件的发生率。结果两组术前BNP水平比较,差异无统计学意义(P>0.05)。与术后24 h内相比,两组术后6个月的LVEF增高、LVEDV降低(P<0.01);术后6个月,治疗组LVEF较对照组高LVEDV较对照组减低(P<0.05)。治疗组不良心血管事件的发生率低于对照组(P<0.05)。结论 p-PCI术后早期应用rhBNP可改善急性心肌梗死患者的心室重构,且不良心血管事件发生率较低。更多还原

【Abstract】 Objective To explore the effect of recombinant human brain natriuretic peptide( rhBNP) on cardial remodeling after primary percutaneous coronary intervention( p-PCI) in patients with acute myocardial infarction. Methods Eighty-three patients with acute ST segment elevation myocardial infarction underwent p-PCI within 12 hours after attack,and were divided into treatment group( n = 39) and control group( n =44). Control group was given routine therapy after p-PCI,while treatment group was administered intravenously rhBNP after p-PCI besides routine therapy. The plasma levels of brain natriuretic peptide( BNP) were detected in both groups before p-PCI,and echocardiography was conducted for the measurement of left ventricular ejection fraction( LVEF) and left ventricular end-diastolic volume( LVEDV) within 24 hours after p-PCI and after 6 months of p-PCI. The incidence of main adverse cardiovascular events( MACE) within6 months after p-PCI was recorded. Results There was no significant difference in the BNP level between two groups before p-PCI( P > 0. 05).For two groups,LVEF increased and LVEDV decreased after 6 months of p-PCI compared to these indices within 24 hours after p-PCI( P < 0. 01). After 6 months of p-PCI,treatment group obtained higher LVEF and lower LVEDV compared to control group( P < 0. 05). The incidence of MACE of treatment group was lower than that of control group( P < 0. 05). Conclusion The application of rhBNP in early stage after p-PCI can improve the cardial remodeling of patients with acute myocardial infarction,and has lower incidence of MACE.更多还原