重组人脑利钠肽对老年急性心肌梗死急诊介入术患者心功能的影响

Recombinant human brain natriuretic peptide in clinical research on postoperative emergency treatment in elderly patients with acute myocardial infarction

目的探讨重组人脑利钠肽(新活素)对老年急性心梗急诊介入患者心功能的影响。方法回顾性分析本院2014年1月~2015年5月收治的84例ST段抬高型急性心肌梗死病人的临床资料,其中对照组42例实施术后常规治疗,观察组42例实施术后常规治疗联合重组人脑利钠肽治疗,观察两组急性心梗患者不同时间点的肌钙蛋白、血管紧张素II、醛固酮、CRP(C反应蛋白)、肾素以及心功能(LVEDV、LVEF、LVESV等)临床指标。结果治疗后与对照组比较,观察组患者肌钙蛋白于术后24h显著降低(P<0.05);CRP于术后10、24h及1周时明显降低,LVEDV、LVESV于术后4周时明显降低,组间差异均有统计学意义(P<0.05);观察组患者LVEF于术后1d及术后1、4周时均明显升高,组间差异有统计学意义(P<0.05);且治疗后与对照组比较,观察组术后不同时区间的肾素水平均明显降低,组间差异亦有统计学意义(P<0.05)。结论老年心梗患者在进行PCI手术后,运用重组人脑利钠肽可以使肾素、血管紧张素以及醛固酮等指标水平显著降低,阻滞心脏重构,可有效改善患者的心功能指标,促进患者预后。

Objective To investigate the effects of recombinant human brain natriuretic peptide in elderly patients with acute myocardial infarction patients with emergency percutaneous coronary intervention（PCI）.Methods 84 patients with ST segment elevation acute myocardial infarction were divided into control group（42 cases）and observation group（42 cases）.The control group was treated with postoperative routine treatment.The observation group was treated with postoperative routine treatment combined with recombinant human brain natriuretic peptide.The cardiac troponin,vascular angiotensin II,aldosterone,CRP（C-reactive protein）,plasma renin activity and heart function indexes of LVEDV and LVEF,LVESV and other clinical indicators were observed.Results The troponin 24 hafter operation of observation group was significantly decreased,compared with that of control group（P〈0.05）.CRP 10 h,24 hand a week after operation of observation group were significantly decreased,compared with that of control group（P〈0.05）.LVEDV LVESV 4 weeks after operation of observation group were significantly decreased,compared with that of control group（P〈0.05）.LVEF 1 D,1 week,4 weeks after operation of observation group were significantly decreased,compared with that of control group（P〈0.05）.The angiotensin II and aldosterone levels were significantly decreased after operation.Conclusion The elderly patients with acute myocardial infarction treated by primary percutaneous coronary intervention using recombinant human brain natriuretic peptide can effectively reduce the renin,angiotensin and aldosterone level,block cardiac remodeling and improve cardiac function in patients and the prognosis.