NT-proBNP和MMP-9与急性心肌梗死患者早期左室重构的相关性研究

Prognostic Value of N-terminal pro-B-type Natriuretic Peptide and MMP-9 in Early Left Ventricular Re-modeling After Acute Myocardial Infarction

【目的】探讨氨基末端B型脑钠肽前体（N T‐proBN P ）、基质金属蛋白酶‐9（M M P‐9）对急性心肌梗死（AMI）患者经皮冠脉介入治疗（PCI）术后早期心室重构的影响及其相关性。【方法】根据PCI术后4周时92例AMI患者左心室容积增加率的不同，将其分为左室重构组，非左室重构组，并设稳定性冠心病对照组。比较患者NT‐proBNP、MMP‐9水平及其与PCI术后患者的左室收缩末期容积（ LVESV）和舒张末期容积（LVEDV）、左室射血分数（LVEF）、左室收缩末容积指数（ LVESVI）、左室舒张末容积指数（LVEDVI）等的关系。【结果】AMI患者PCI治疗前后血浆NT‐proBNP和MMP‐9水平较稳定型冠心病对照组明显升高；左室重构组血浆 NT‐proB‐NP、MMP‐9水平持续增高，与非左室重构组在PCI术后7 d比较差异有统计学意义（ P＜0．01）。血浆NT‐proB‐NP、MMP‐9水平与LVEDV均呈明显正相关（ P ＜0．01），与LVEF均呈明显负相关（ P ＜0．05）。【结论】AMI患者血浆NT‐proBNP、MMP‐9水平与左室重构指标有相关性，可作为AMI早期左室重构的预测因子。

[Objective] To explore the relationship between N‐terminal pro‐B‐type natriuretic peptide （NT‐proBNP） and matrix metalloproteinase‐9 （MMP‐9） in early left ventricular remodeling after acute myocardial infarction （AMI） .[Methods] A total of 92 AMI patients were divided into two groups based on left ventricular end‐diastolic volume index . The plasma levels of NT‐proBNP and MMP‐9 were determined by radioimmunoassay .Left ventricular end systolic volume （LVESV） ,left ventricular end diastolic volume （LVEDV） ,ejection fraction （EF） and left ventricle mass （LVM ） were measured by echocardiography .[Results] The plasma levels of NT‐proBNP and MMP‐9 were higher in AMI group than those in control group （ P〈0 .01） .And their levels kept rising in left ventricular remodeling group .The plasma levels of both were significantly positively correlated with LVEDV （P〈0 .01） and negatively with LVEF （ P〈0 .05） .[Conclu‐sion]In AMI patients ,the plasma levels of NT‐proBNP and MMP‐9 are correlated with left ventricular remodeling indica‐tors .And both may be used as predictors for early left ventricular remodeling of AMI .