血浆B型脑钠肽与急性ST段抬高型心肌梗死患者的临床关系研究

Clinical study of the relationship between plasma B type natriuretic peptide in patients with acute ST segment elevation myocardial infarction

目的:分析初发急性ST段抬高型心肌梗死(STEMI)患者血浆B型脑钠肽(BNP)水平与住院期间左室射血分数(LVEF)、左室舒张末内径(LVEDd)、室壁瘤形成(LVA)及主要不良心脏事件(MACE)之间的关系,评价BNP与STEMI患者的临床关系。方法:选取非心衰初发STEMI患者86例,按照BNP水平分为BNP<100 ng/L组,100 ng/L≤BNP<200 ng/L组和BNP≥200 ng/L组,比较各组住院期间的LVEF、LVEDd、LVA发生率和MACE的发生率。采用SPSS 19.0统计软件进行数据分析,计量资料用均数±标准差表示,用t检验进行分析,多组均数比较采用单因素方差分析,计数资料采用χ2检验,以P<0.05为差异有统计学意义。结果:BNP≥200 ng/L组LVEF最低,LVEDd最大,MACE发生率最高(P=0.000),BNP<100 ng/L组LVEF最高,LVEDd最小,MACE发生率最低(P=0.000),而100 ng/L≤BNP<200 ng/L组的三个统计指标介于两者之间(P=0.000)。结论:STEMI患者住院期间的BNP水平越高,心功能越差,心肌重塑程度越高,LVA发生率和MACE发生率越高。

Objective To analyze the relationship between B natriuretic peptide（BNP） level and the left ventricular ejection fraction（LVEF）,left ventricular end diastolic diameter（LVEDd）,left ventricular aneurysm（LVA） and major adverse cardiac events（MACE） of hospitalization of patients with primary acute segment elevation myocardial infarction（STEMI）.Method We selected 86 cases of patients without heart failure in primary STEMI,and divived into BNP100 ng/L group,100ng/m ≤ BNP200 ng/L group and BNP ≥ 200 ng/L group,according to the level of BNP,and then compared the LVEP,LVEDP,occurance of LVA,occurance of MALE of each group of hospitalization.Data aralysis was done by SPSS19.0 statistical software,measurerment data was expressed by mean ± standard deviation,and was analyzed by t-test,multiple group comparison adopted single factor Vaviance analysis.Count data.adopted χ2 test and P0.05 had a statistically significant difference.Results In BNP ≥ 200ng/L group LVEF was minimum,LVEDd was maximum,occurance of MACE was maximum.In BNP100 ng/L group LVEF was maximum,LVEDd was minimum,occurance of MACE was minimum,while in 100 ng/L≤ BNP200 ng/L group,these three indicators was between those of the other two goups.Conclusion In the STEMI patients of hospitalization,the higher BNP level,the worse the heart function,the higher degree of myocardial remodeling,and the higher occurance of LVA and MACE.