急性心肌梗死PCI术后NT-proBNP变化及其临床意义

Acute myocardial infarction after PCI NT-proBNP and its clinical significance

目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入术(PC1)治疗后血浆N氨基末端脑钠肽前体(NT-proBNP)水平的变化及临床意义。方法选择2011-01—2013-11间收治的81例急性心肌梗死患者,根据治疗方式的不同随机分为PCI组43例和非PCI组38例,采用酶联免疫吸附法检测血浆NTproBNP水平,应用超声心动图测定左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)及左室舒张末期容积(LVEDV)。结果两组患者在入院时血浆NT-proBNP浓度差异无统计学意义(P>0.05)。入院经治疗后7、30 d两组患者血浆NT-proBNP浓度均显著降低(P<0.05)。PCI组降低优于非PCI组,差异有统计学意义(P<0.05)。两组患者治疗后LVEDD、LVEDV分别为(45.61±4.12)mm、(101.58±18.76)mL,较治疗前降低,LVEF为(53.19±7.33)%,较治疗前升高,差异有统计学意义(P<0.05)。结论血浆NT-proBNP的增高能预测AMI面积及早期心室重构。说明PCI术在改善急性心肌梗死患者心功能及判断预后有着积极意义。

Objective To investigate the acute myocardial infarction（ AMI） patients after percutaneous coronary intervention（ PC1） and its clinical significance of plasma N amino terminus of the treatment of brain natriuretic peptide（ NT-proBNP） levels. Methods Our hospital from January 2011 to November 2013 were treated 81 cases of acute myocardial infarction,according to different PCI were randomly divided into treatment group 43 cases and 38 cases of non-PCI group,using enzyme-linked immunosorbent assay of plasma NTproBNP levels, measured by echocardiography left ventricular end-diastolic diameter（ LVEDD）,left ventricular ejection fraction（ LVEF） and left ventricular end-diastolic volume（ LVEDV）. Results The two groups of patients on admission plasma concentration of NT-proBNP was no significant difference（ P 〉 0. 05）. 7 days after admission after treatment,30 days both groups of plasma NT-proBNP concentrations were significantly lower（ P 〈 0. 05）. Reduce the PCI group than the non-PCI group,the difference was statistically significant（ P 〈 0. 05）. Two groups of patients after treatment LVEDD,LVEDV were（ 45. 61 ± 4. 12） mm,（ 101. 58 ± 18. 76） ml,compared with before treatment,LVEF was（ 53. 19 ± 7. 33） %,compared with pre-treatment increased,the difference was statistically significant（ P 〈 0. 05）. Conclusion The increased plasma NT-proBNP can predict AMI size and early ventricular remodeling. Description of PCI in acute myocardial infarction improved cardiac function and prognosis in patients with a positive meaning.