介入治疗对冠心病患者血浆脑钠素水平及心室重塑的影响

Effects of percutaneous coronary intervention on plasma level of brain natriuretic peptide and left ventricular remodeling

目的观察介入治疗对冠心病合并心功能不全患者再次发生心绞痛后血浆脑钠素水平及心室重塑的影响。方法50例冠心病合并心功能不全患者,随机分为对照组25例和介入组25例,应用酶链免疫吸附法测定治疗前、治疗后6个月时的血浆脑钠素水平,及心脏超声诊断仪测量同期心脏的结构和功能。结果①对照组、介入组与正常组相比血浆脑钠素(BNP)水平在治疗前及6个月后差异均有统计学意义(P<0.01);对照组、介入组血浆脑钠素(BNP)水平在治疗前相比差异无统计学意义(P>0.05),介入治疗6个月后相比差异有统计学意义(P<0.05)。②治疗前两组间患者左心室舒张末期内径、左心室舒张末期容积、左心室收缩末期容积及射血分数相比差异无统计学意义(P>0.05);6个月后两组间患者左心室舒张末期内径、左心室舒张末期容积、左心室收缩末期容积及射血分数相比差异均有统计学意义(P<0.05)。③两组患者血浆脑钠素(BNP)水平与同期左心室收缩末期容积呈正相关(r=0.51,P≤0.05),与左室射血分数呈负相关(r=-0.43,P≤0.01)。结论冠心病合并心功能不全患者再次发生心绞痛后进行介入治疗,可使血浆脑钠素水平下降,并改善心室重塑。

Objective This study was designed to assess the clinical effects of percutaneous coronary intervention on plasma level of brain natriuretic peptide and left ventricular remodeling. Methods Plasma levels of brain natriuretic peptide of 50 patients and 20 healthy subjects were measured with ELISA before and 6 months after treatment. Constructive and functional parameters were obtained by echocardiography. Results Plasma levels of brain natriuretic peptide of these patients in theraputic group and control group were significantly higher than those healthy subjects before and after 6 months, but there was difference between theraputic group and con trol group after 6 months. The changes of constructive and functional parameters was not significant difference between theraputic group and control group before, but was significant difference after 6 months. Plasma levels of brain natriuretic peptide was positively correlated with LVSDd, and negatively correlated with LVEF. Conclusion It suggests that plasma levels of brain natriuretic peptide was decreased by percutaneous coronary intervention for CHD with heart failure after 6 months, and the changes of constructive and functional parameters was positive.