重组脑利钠肽对急性前壁心肌梗死PCI术后心力衰竭患者心肌梗死面积的影响

Effect of brain natriuretic peptide on myocardial infarction area of heart failure patients with acute anterior myocardial infarction underwent percutaneous coronary intervention

目的应用心肌ECT检查半定量计算心肌梗死面积，进而分析重组脑利钠肽对急性心肌梗死PCI术后心力衰竭患者心肌梗死面积的影响。方法回顾分析急性前壁心肌梗死行急诊介入治疗后出现心力衰竭患者102例，所有患者均被纳入唐山市工人医院PCI术后随访系统，其中脑利钠肽组51例，选取使用硝酸甘油者51例为对照组。观察两组介入治疗术前、术后即刻TIMI血流分级。观察术前心肌酶、心肌酶峰值。术后6个月作为随访截点，行心肌ECT检查对比两组心肌梗死面积差异。结果两组患者年龄、性别、血压、心率、高血压病率、糖尿病率、吸烟及发病到PCI治疗时间比较差异无统计学意义（P〉0．05）。两组患者罪犯血管部位、侧支循环、术前TIMI血流分级、术后即刻TIMI血流分级比较差异均无统计学意义（P〉0．05）。脑利钠肽组CK—MB峰值、CK峰值明显低于对照组（P〈0．05）。术后6个月随访，脑利钠肽组心肌梗死面积较对照组明显缩小（P〈0．05）。结论重组脑利钠肽可以挽救濒临坏死心肌，明显减小心肌梗死面积。

Objective Presently, doctors study the effects of rhBNP on the prognosis of patients with heart failure more than on myocardial infarction area of patients with heart failure, this paper aimes to analyze the effects of rhBNP on myocardial infarction area of patients with heart failure after percutaneous coronary intervention （PCI） operation by data from ECT examination. This retrospective study included 102 patients. There were 51 patients in BNP group and 51 patients in control group treated with nitroglycerin. The TIMI flow classification before and after interventional therapy and the peak of myocardial enzymes of the two groups were compared. Myocardial infarction area by the end of 6 months follow - up was semiquantified by ECT and compared between the two groups. Methods Results There was no significant difference between the two groups on age, gender, blood pressure, heart rate, hypertension, diabetes, smoking, time of onset to PCI （P 〉 0.05）. There was no significant difference between the two groups on the infarction related artery, collateral circulation, the TIMI flow classification before and after interventional therapy （P 〉 0.05 ）. The BNP group＇s CK - MB peak value was lower than the control group, and the BNP group＇s myocardial infarction area was smaller than the control group （P 〈 0.05 ）. Six months after PCI, myocardial infarction area in BNP group was smaller than the control group （ P 〈 0.05 ）. Conclusion rhBNP can reduce myocardial infarction area and protect the myocardial cells from necrosis; therefore it clinically has a therapeutic effect on acute myocardial infarction.