急性心肌梗死溶栓后左心功能变化的研究

Investigation on left ventricular function of patients with thrombolysis after acute myocardial infarction

目的探讨溶栓治疗对急性心肌梗死(AMI)患者左室重构、血浆脑利钠肽(BNP)水平的影响及左心功能改善作用,以指导临床合理治疗和判断预后。方法将发病12h之内的首次急性前壁心肌梗死患者46例分为溶栓开通组23例和非再通组23例。对两组患者分别于入院即刻和发病后7d测定血浆BNP浓度,于发病l周后行超声心动图检查,观察左室重构、左心功能。结果与非再通组相比,溶栓开通组发病第7天血浆BNP水平显著降低(P<0.05),发病1周后,溶栓开通组心功能改善明显优于非再通组(P<0.05)。结论溶栓治疗AMI后血浆BNP浓度降低,阻抑左室重构,左心功能改善,心脏不良事件减少,值得基层医院推广。

Objective To investigate the impact of thrombolytic therapy on the left ventricular remodeling,the plasma brain natriuretic peptide（BNP） leveland,the improvement of left ventrieular function of patients with acute anterior myocardial infarcton for guiding the reasonable clinical therapy and estimating the prognosis.Methods Forty six patients with acute anterior myocardial infarcton within 12 hours were divided into thromboiytic repeffusion group（n = 23） and non repeffusion group（n = 23）.The plasma concentrations of BNP were measured immediatdy and at 7th day after infarction.All patients were given ultrasonic cardiography in first week after infarction,to observe the left ventrieular remodeling,left ventrieular function.Results The plasma BNP levels in 7th day of thromboiytic repeffusion group was much lower than that of non repeffusion group（P 〈0.05）,the left ventrieular function of thromboiytic repeffusion group was significantly better than that of non repeffusion group（P 〈0.05）.Conclusion Carrying out thrombolytic therapy for the patients with acute myocardial infarction can decrease the plasma BNP level,prevent left veatricular remoaelillg,improve the left wentricular function and reduce the cardiac events,it is worthy of application in primary hospitals.