急性心肌梗死早期冠状动脉介入治疗后血浆脑钠素水平与肌酸磷酸激酶MB峰值变化的关系

Relation of plasma brain natriuretic peptide to serum creatine kinase MB level in patients with acute myocardial infarction following primary percutaneous coronary intervention

目的探讨急性心肌梗死(AMI)患者接受早期冠状动脉介入(PCI)治疗后血浆脑钠素(BNP)水平与肌酸磷酸激酶MB(CK-MB)峰值变化的关系,进而通过BNP来定量评价梗死相关动脉是否及时再通。方法63例AMI患者根据PCI时间分为直接组和非直接组。所有患者均在入院时、入院后4、24、48h测定BNP水平。CK-MB峰值测定:入院即时采血检查CK-MB,入院第1天每3h测一次,第2天每6h测一次,第3天每12h测一次。结果患者BNP水平在入院后缓慢上升,并于第24小时达到高峰值,第48小时开始下降。非直接PCI组BNP水平相对于直接PCI组显著增高(P<0.01)。直接PCI组达CK-MB峰值时间明显比非直接PCI组前移。结论血浆BNP水平测定是评价AMI早期PCI后梗死相关动脉是否及时再通的客观指标,可指导临床治疗方案的选择。

Objective To study the relation between plasma brain natriuretic peptide （BNP） and serum creatine kinase MB （CK-MB） level,in patients with acute myocardial infarction （AMI） following primary percutaneous coronary intervention （PCI）. Methods Sixty-three consecutive patients with AMI were divided into two groups according to the timing of PCI, namely direct PCI and indirect PCI groups. Plasma BNP levels were measured in all patients on admission and at 4, 24 and 48 h after admission. The CK-MB level was measured every 3 h on the first day of hospitalization, every 6 h on the second day and every 12 h on the third day. Results BNP level increased gradually following admission and began to decrease 48 h after admission in the two groups of patients. The peak BNP level occurred at 24 h after admission, and the BNP levels in patients of indirect PCI group were significantly higher than that of direct PCI group at 4, 24 and 48 h after admission. The peak CK-MB level of the direct PCI group occurred significantly earlier than that of the indirect group. Conclusion Plasma BNP level may serve as an important objective indicator for recanalization of the infarct-related arteries following PCI in the early stage of AMl, which can help in the decision on clinical treatment plans for AMI.