急性心肌梗死早期血浆脑钠素水平对左室重塑的影响

The relation between early changes of plasm brain natriuretic peptide and left ventricular remodeling in patients with acute myocardial infarction

目的探讨急性心肌梗死（AMI）早期血浆脑钠素与左室重塑的关系。方法40例AMI患者分为依那普利组及常规治疗组各20例,采用放射免疫法测定入院后14 d内血浆脑钠素水平;超声心动图测定同期及3个月左室舒张末容积指数（LVEDVI）、左室收缩末容积指数（LVESVI）及左室射血分数（LVEF）。结果常规治疗组入院后即刻血浆脑钠素水平较健康对照组明显升高（P＜0．01）,5、14 d较入院即刻进一步升高（P＜0．05）。AMI患者5、14 d血浆脑钠素水平与同期及3个月LVEDVI、LVESVI呈正相关（P＜0．05～0．01）。与常规治疗组相比,依那普利组脑钠素与心室容积指数一致性下降。结论AMI早期血浆脑钠素升高与左室重塑密切相关。

Objective To investigate the relation between early changes of plasm brain natriuretic peptide （BNP） and left ventricular remodeling in patients with acute myocardial infarction（AMI）. Methods 40 patients with AMI were divided into enapril group（treatment group, n = 20） and conven-tional treatment group （control group, n = 20）. Plasm BNP concentrations were measured in patients with AMI on admission and days 1,5 and 14. Left ventricular end diastolic volume index（LVEDVI）,left ventricular end systolic volume index（LVESVI） and left ventricular ejection fraction（LVEF） were measured by echocardiogram on days 1,5 and 14, and after 3 months. Results The plasma BNP level was significantly increased on admission in control group as compared with that of the healthy subjects（P 〈 0.01 ） and increased further on days 5 and 14 than that on admission（P〈 0.05 ）. The plasma BNP level on days 5 and 14 in patients with AMI correlated with LVEDVI and LVESVI measured at thesame day （ P〈 0.01 ）, and also correlated with LVEDVI and LVESVI measured after 3 months（ P 〈 0.05 -- 0.01 ）. Compared with control group and enapril treatment group it showed decreased in plasma BNP level corresponding to the decrease of ventricle volume index. Conclusion The increased plasma BNP level is correlated with left ventricular remodeling after AMI.