急性心肌梗死患者血浆脑钠素检测的临床意义

目的探讨急性心肌梗死患者(AMI)血浆脑钠素(BNP)水平的变化特点和临床意义。方法将90例首次急性前壁心肌梗死患者分为急诊PCI组(30例)、溶栓开通组(30例)和对照组(30例)。测定入院即刻和发病后第7天血浆BNP浓度,并随访6个月内主要心脏事件的发生情况。结果1)入院即刻血浆BNP浓度虽较正常值升高但三组间无显著性差异(P>0.05)。发病后第7天急诊PCI组和溶栓开通组血浆BNP水平较对照组显著降低(P<0.01,P<0.05),而此两组间无显著差异(P>0.05)。2)6个月随访,急诊PCI组和溶栓开通组不稳定型心绞痛(P<0.01,P<0.05)、心力衰竭(P<0.01,P<0.05)和复合终点事件(P<0.01,P<0.01)较对照组明显减少。结论血浆BNP水平可评估AMI患者的治疗效果及预后。

Objective To investigate the plasma brain natriuretic peptide （BNP） level change in patients with acute myocardial infarcton （AMI）. Methods 90 patients with acute anterior myocardial infarction were divided into PCI group （n=30）, thrombolytic reperfusion group （n=30） and the contrast group （n=30）. The plasma concentrations of BNP were measured immediately and at 7th day after infarction. All patients were followed up for half a year in major cardiac events. Results 1）The plasma BNP levels of all groups increased immediately after admission, but there was no significant difference among the three groups （P〉0.05）. The plasma BNP level at 7th day of PCI group and thrombolytic reperfusion group were much lower than that of the contrast group （P〈0.01,P〈0.05）, but there was no significant difference between the two groups （P〉0.05）. 2）The unstable angina （P〈0.01,P〈0.05）, heart failure （P〈0.01,P〈0.05） and composite events （P〈0.01 ,P〈0.01） were decreased more significantly in the PCI group and thrombolytic reperfusinn group than that in the contrast group in half a year. Conclusion The plasma BNP level can be a way to evaluate the treatment efficiency and estimate the prognosis.