急性心肌梗死患者左心室舒张功能及Tei指数的变化与BNP的关系

Relation of plasma B-type natriuretic peptide levels to the changes in left ventricular diastolic function and Tei index in patients with acute myocardial infarction

目的:探讨急性心肌梗死患者左心室舒张功能及Tei指数与B型利钠肽(BNP)的关系。方法:连续性入选210例前壁急性心肌梗死患者,测定症状发作后平均(24.2±10.4)h的血浆BNP水平。利用超声心动图、组织多普勒显像(TDI)测定患者心梗后30d时室间隔厚度、射血分数和反映左心室舒张功能的参数及Tei指数。以性别、年龄、心率、血压、空腹血糖、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等因素进行多变量分析。并探讨两者之间的关系。结果:根据血浆BNP水平将所有患者分为4组,随血浆BNP升高,Tei指数呈增高趋势。多因素logishic回归分析显示,BNP与左室等容舒张时间(IRT)、DT、e/a、E/A、S/D及Tei指数相关,且独立于年龄、性别、血脂异常、糖尿病、高血压、贫血等危险因素。BNP越高,则Tei指数越增高(β=0.31,P<0.001)。结论:BNP与急性心梗后的心脏舒张功能密切相关,BNP与Tei指数均可作为评价急性心梗患者近期临床预后的指标。

Objective：To evaluate the relationship between plasma B-type natriuretie peptide levels and left ventricular diastolic function including Tei index in patients with acute myocardial infarction （AMI）. Methods： A total of 210 patients with acute anterior myocardial infarction were included in this study. Plama BNP was measured at a median of （24. 6 ± 10. 2） hours from symptom onset. Left ventricular diastolic function including Tei index was measured using tissue Doppler imaging within 30 days after AMI. Gender, age, heart rate, blood pressure, fasting plasma glucose, total cholesterol （TC）, triglyceride （TG）, high-density lipoprotein cholesterol （ HDL-C）, low-density lipoprotein cholesterol （LDL C）, and coronary disease severity were analyzed. Results：Patients were divided into four groups according to their BNP levels. The Tei index was elevated with the increase in plasma BNP levels. Multivariate logistic regression analyses showed that BNP was independently associated with IRT,DT, e/a, E/A, and S/D. Multiple regression analysis showed that Tei index was independently associated with BNP（P〈0.01）. Conclusion：BNP is closely related to left ventricular diastolic functionafter acute myocardial infarction. BNP and Tei index can be used as short-term clinical prognostic factors in patients with acute myocardial infarction.