老年急性心肌梗死患者在冠状动脉介入术后采用重组人脑利钠肽治疗的应用价值

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

目的:研究老年急性心肌梗死患者术后采用重组人脑利钠肽结合常规治疗后患者的预后效果。方法:收集本院92例ST段抬高急性心肌梗死患者临床数据,应用随机方法分组,包括46例经皮冠状动脉介入术(PCI)联合常规治疗的对照组,以及46例PCI术后联合重组人脑利钠肽治疗的观察组。观察术后两组患者CRP、心肌蛋白、LVESV、LVEDV、LVEF、肾素、血管紧张素II和醛固酮水平变化。结果:对照组术后12h、24h与观察组比较,观察组CRP、肌钙蛋白改善更佳(P均<0. 05);心脏超声心动图检查也显示观察组术后1周、4周的血流动力学改善要较对照组更显著(P均<0. 05);术后各时间段的肾素-血管紧张素-醛固酮等肾功能指标检测,也均是观察组的指标改善好于对照组(P均<0. 05)。结论:对老年急性心肌梗死患者在实施PCI手术与常规对症治疗的同时,于术后联合应用重组人脑利钠肽治疗,能够进一步改善患者的心功能指标,加快术后恢复。

Objective:Clinical analysis of combined treatment with recombinant human brain natriuretic peptide after PCI in elderly patients with acute myocardial infarction.Methods:The clinical data of92patients with ST acute myocardial infarction were collected,including46patients with PCI plus conventional therapy,and46patients with postoperative PCI combined with human brain natriuretic peptide.The changes of CRP,myocardial protein,LVESV,LVEDV,LVEF,renin,angiotensin II and aldosterone levels were observed in the two groups.Results:Compared with the control group at12h and24hours after operation,the improvement of CRP and troponin was more obvious in the observation group(P<0.05).The cardiac ultrasonography was performed1week and4weeks after operation.In the observation group,the improvement of cardiac function indexes such as LVEF,LVEDV and LVESV in the observation group was more significant than that in the control group(P<0.05),renal function indexes such as renin-angiotensin-aldosterone at various time points after operation The detection was also better than the control group in the observation group(P<0.05).Conclusion:In the elderly patients with acute myocardial infarction,the implementation of PCI surgery and conven-tional symptomatic treatment,combined with the application of human recombinant brain natriuretic peptide treatment,can further improve the patient′s cardiac function indicators and accelerate postoperative recovery.