急性心肌梗死患者血浆脑钠肽水平变化及其与左心室室壁瘤形成、左心室重构的关系研究

Changes of Plasma BNP Level and Its Correlation with Left Ventricular Aneurysm and Left Ventricular Reconstitution in Patients with Acute Myocardial Infarction

目的观察急性心肌梗死(AMI)患者血浆脑钠肽(BNP)水平变化,探讨其与左心室室壁瘤(LVA)形成、左心室重构的关系。方法选取2013年2月—2015年1月泗洪县人民医院收治的AMI患者78例,根据入院时左心室造影(LVG)结果分为LVA组41例和非LVA组37例。比较两组患者治疗后6 h、3 d、7 d及6个月血浆BNP水平,治疗后即刻、治疗后6个月左心室重构指标〔左心室射血分数(LVEF)、左心室收缩末期容积指数(LVESVI)、左心室舒张末期容积指数(LVEDVI)和左心室舒张末期压(LVEDP)〕。结果 LVA组患者治疗后6 h、3d、7 d及6个月血浆BNP水平高于非LVA组(P<0.05)。除治疗后即刻LVEDVI外,两组患者治疗后即刻、治疗后6个月LVEF、LVESVI、LVEDVI及LVEDP比较,差异有统计学意义(P<0.05);治疗后6个月,两组患者LVEF高于治疗后即刻,LVESVI、LVEDVI及LVEDP小于治疗后即刻(P<0.05)。Pearson相关性分析结果显示,LVA组患者血浆BNP水平与LVESVI、LVEDVI、LVEDP呈正相关(r值分别为0.621、0.592、0.763,P<0.05),而非LVA组患者血浆BNP水平与LVESVI、LVEDVI、LVEDP均无直线相关性(r值分别为0.019、0.101、0.152,P>0.05)。结论AMI并发LVA患者血浆BNP水平明显升高,血浆BNP水平可在一定程度上反映LVA形成,且与LVA病情变化、左心室重构密切相关,可作为诊断LVA形成、左心室重构的参考指标之一。

Objective To observe the changes of plasma BNP level of patients with acute myocardial infarction, to investigate its correlation with left ventricular aneurysm and left ventricular reconstitution. Methods A total of 78 patients with acute myocardial infarction were selected in the People＇s Hospital of Sihong County from February 2013 to January 2015, and they were divided into A group （n --41, with left ventricular aneurysm） and B group （n = 37, without left ventricular aneurysm） according to the LVG results. Plasma BNP level after 6 hours, 3days, 7 days and 6 months of treatment, LVEF, LVESVI, LVEDVI and LVEDP immediately after treatment and after 6 months of treatment were compared between the two groups. Results Plasma BNP level of A group was statistically significantly higher than that of B group after 6 hours, 3days, 7 days and 6 months of treatment, respectively （P 〈0. 05）. There were statistically significant differences of LVEF, LVESVI, LVEDVI and LVEDP between the two groups immediately after treatment and after 6 months of treatment （except for LVEDVI immediately after treatment） ; LVEF of the two groups after 6 months of treatment were statistically significantly higher than those immediately after treatment, while LVESVI, LVEDVI and LVEDP of the two groups after 6 months of treatment were statistically significantly lower than those immediately after treatment （ P 〈 0. 05 ）. Pearson correlation analysis showed that, plasma BNP level was positively correlated with LVESVI （ r = 0. 621 ）, LVEDVI （ r = 0. 592 ） and LVEDP （ r = 0. 763 ） in acute myocardial infarction patients complicated with left ventricular aneurysm, respectively （P 〈0. 05）, while plasma BNP level was not linearly correlated with LVESVI （r =0. 019 ）, LVEDVI （ r =0. 101 ） or LVEDP （ r =0. 152 ） in acute myocardial infarction patients did notcomplicated with left ventricular aneurysm （P 〉 0.05）. Conclusion The plasma BNP level of acute myocardial infarction patients complicated with left ventricular aneurysm is significantly elevated, plasma BNP level can reflect the incidence of left ventricular aneurysm to a certain extent, and it is closely related with the evolution of left ventricular aneurysm and left ventricular reconstitution, may be served as one of reference index of left ventricular aneurysm and left ventricular reconstitution.