BNP与急性心肌梗死后左室重构的相关性及培哚普利的影响

THE CORRELATION BETWEEN BRAIN NATRIURETIC PEPTIDE AND LEFT VENTRICULAR REMODELING IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION AND THE INFLUENCE OF PERINDOPRIL TO BNP

目的探讨急性心肌梗死后BNP变化曲线及其与左室重构的相关性,同时观察培哚普利对其影响。方法入选急性ST段抬高型心肌梗死患者68例分为培哚普利治疗组(37例)、对照组(31例)。所有患者均测定入院后第1、3、7、14及30天全血BNP浓度及第1、7及30天EDD及LVEF。结果两组BNP水平都于第3天达最高峰,而后逐渐下降,至30d时治疗组降至入院时水平,而在对照组第14天又出现第二高峰,至第30天时仍明显高于入院时水平。EDD及LVEF在治疗组前后没有显著变化(P>0.05),在对照组第30天时EDD显著增加(P<0.05)、LVEF显著下降(P<0.05);两组第1天BNP与EDD没有相关性,第7、30天出现明显相关性;BNP始终与LVEF呈现明显负相关。结论急性心肌梗死后BNP水平升高并且与左室重构相关,培哚普利可以影响BNP变化。

Objective To explore the correlation between brain natriuretic peptide(BNP) and left ventricular remodeling in patients after acute myocardial infarction and the influence of Perindopril to BNP.Methods Sixty eight patients with acute ST elevation myocardial infarction(ASTEMI) were random divided into Perindopril groups(37 cases) and control groups(31 cases). Blood samples of BNP at 1,3,7,14 and 30 days were measurement and end diastolic dimension(EDD) and LVEF were performed at 1,7 and 30 days.Results Serum BNP levels become elevated after the onset of symptoms of AMI,peak at 3 days, and return to initial level in Perindopril group and remain elevated up to 30 days in control groups.The EDD and LVEF were not statistical difference in Perindopril groups.EDD increased and LVEF declined significantly at 30 days(P<0.05) in control group.No correlation between BNP and EDD at 1 day but there is significantly correlation at 7,30 days between BNP and EDD in two groups.There was a negative correlation between BNP and EDD from beginning to end(P<0.05).Conclusion Application of Perindopril may be a helpful method to restrain BNP level and left ventricular remodeling after AMI.