重组人脑利钠肽对急性前壁心肌梗死患者血清可溶性基质溶素-2的影响及预后

Effects of recombinant human brain natriuretic peptide on serum soluble ST2 in patients with acute anterior wall myocardial infarction and its prognosis

目的探讨重组人脑利钠肽(rhBNP)对急性前壁心肌梗死患者血清可溶性基质溶素-2(ST2)和预后的影响。方法将80例行急诊经皮冠状动脉介入手术(PCI)的急性前壁心肌梗死患者按照随机数字表法分为两组,对照组39例采用常规治疗方案,研究组41例在对照组基础上增加rhBNP治疗。对比两组患治疗前后血流动力学指标、心功能指标、血清可溶性ST-2、肌酸磷酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)以及预后的差异。结果与对照组相比,研究组患者PCI术后心率(HR)、呼吸(RR)、中心静脉压(CVP)明显下降(P<0.05),血氧饱和度(SaO 2)明显升高(P<0.05);血清可溶性ST2、CK、CK-MB、cTnI水平明显下降(P<0.05);左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)明显下降(P<0.05),左心室射血分数(LVEF)明显升高(P<0.05)。研究组术后1年主要心脏不良事件(MACE)发生率低于对照组(19.51%比53.85%,P<0.05),两组1年生存率差异无统计学意义(92.61%比89.05%,P<0.05)。结论rhBNP可稳定急性前壁心肌梗死患者血流动力学,降低血清可溶性ST2水平,延缓左室重构,降低MACE发生率,改善患者预后。

Objective To investigate the impact of the recombinant human brain natriuretic peptide(rhBNP)on patients with acute anterior wall myocardial infarction serum soluble matrix element-2(ST2)and prognosis.Methods 80 cases with acute anterior wall myocardial infarction who were carried out emergency percutaneous coronary interventional(PCI)were randomly divided into two groups,control group(39 cases)with conventional treatment,research group(41 cases)increased rhBNP treatment.Before and after treatment,we compared the differences of hemodynamic indexes,heart function index,serum soluble ST-2,creatine phosphokinase(CK),creatine kinase isoenzyme(CK-MB),troponin(T)and the prognosis between the two groups.Results Compared with the control group,the heart rate(HR),respiration(RR)and central venous pressure(CVP)significantly decreased(P<0.05),and the blood oxygen saturation(SaO 2)increased significantly(P<0.05),Serum soluble ST2,CK,CK-MB and cTnI levels decreased significantly(P<0.05),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)decreased significantly(P<0.05),left ventricular ejection fraction(LVEF)significantly increased after PCI in the research group(P<0.05).The incidence of major cardiac adverse events(MACE)1 year after surgery in the research group was lower than that in the control group(19.51%vs 53.85%,P<0.05),and the difference in 1-year survival rate between the two groups was not statistically significant(92.61%vs 89.05%,P<0.05).Conclusion rhBNP can significantly stabilize the hemodynamics,reduce the level of serum soluble ST2,delay the reconstruction of left ventricle,reduce the incidence of MACE and improve the prognosis of patients with acute anterior wall myocardial infarction.