急性心肌梗死患者静脉溶栓后早期心电图ST段回落幅度与血浆型脑利钠肽变化的观察

RELATIONS BETWEEN EARLY ST-SEGMENT RESOLUTION AND BNP IN FIRST ST-ELEVATED MYOCARDIAL INFARCTION PATIENTS TREATED WITH THROMBOLYSIS

目的探讨急性心肌梗死静脉溶栓再通患者1h ST段回落幅度(STR)与血浆型脑利钠肽(BNP)水平变化的关系及对预后评估的意义。方法 31例溶栓再通的急性心肌梗死患者按静脉溶栓1h ST段回落幅度分成A组(n=13,STR≥50%)和B组(n=18,STR<50%)。测定溶栓前,发病24h和5d时的血浆BNP,进行组内及组间比较。结果组内溶栓后BNP水平高于溶栓前(P<0.05),发病5d低于发病24h的BNP(P<0.05),溶栓前和发病24hBNP组间比较差异无统计学意义(P>0.05),A组发病5d BNP明显低于B组(P<0.01)。结论急性心肌梗死患者静脉溶栓再通患者早期ST段回落幅度(STR)可反映心肌再灌注治疗后的微循环情况,是预测临床预后和检出高危患者简便而可靠的方法。

Objective To study the relations between early ST-segment resolution and BNP in first ST-elevated myocardial infarction patients undergoing thrombolytic therapy and to evaluate the prognostic significance of early ST-segment resolution.Methods ST-segment elevation before and after one hour after thrombolysis were evaluated.The 31 patients were classified into two groups according to early ST-segment resolution：group A（ST-segment resolution ≥50%）;group B（ST-segment resolution 50%）.The levels of serum BNP was detected before thrombolytic therapy and after fall ill 24 hours,5d.Results In the two group ：The levels of serum BNP after thrombolysis were higher than those before thrombolysis（P〈0.05）,the serum BNP levels on the 5th day were lower than those on the 24th hour（P〈0.05）.There were no diference in the BNP both before thrombolysis and on the 24th between the two group,however,the serum BNP levels on the 5th day of group A was lower than those of group B（P〈0.05）.Conclusion Early ST-segment resolution in first ST-elevated myocardial infarction patients treated with thrombolysis reflect the microcirculaion of the myocardial tissue perfusion.This may be a convenient and reliable method for prediction of the prognosis and could be used to detect high risk patients and instruct clinical therapy in patients with AMI.