急性心肌梗死早期使用重组人脑利钠肽对患者预后及生化标志物的影响

Effect of carly use of recombinant human brain natriuretic peptide on prognosis and hiochemical markers in patients with acute myocardial infarction

目的:分析急性心肌梗死(AMI)患者早期应用重组人脑利钠肽(rhBNP)对其预后及生化标志物的影响。方法:选择我院治疗的AMI患者83例,根据计算机产生随机数字将患者分为观察组41例与对照组42例,患者予以抗血小板及溶栓治疗,观察组同时早期予以rhBNP治疗。比较两组干预前、干预24 h、48 h、72 h不同时间点的血清磷酸肌酸激酶同工酶(CK-MB)和氨基末端脑钠肽前体(NT-pro BNP)及心肌肌钙蛋白Ⅰ(cTnⅠ)水平变化,并随访3个月,评估随访期间两组预后情况。结果:干预24 h、干预48 h两组的CK-MB、NT-pro BNP、c Tn Ⅰ水平较干预前均显著升高,且观察组的各指标均低于对照组,差异均有统计学意义(P<0.05);干预72 h两组的各指标均低于干预前,且观察组的血清CK-MB、血清NT-pro BNP均低于对照组,差异均有统计学意义(P<0.05),两组的血清c TnⅠ比较差异无统计学意义(P>0.05)。观察组不良事件总发生率17.07%低于对照组的38.09%,差异有统计学意义(P<0.05)。结论:AMI患者早期应用rhBN可有效改善患者心肌功能,避免患者不良事件,预后较好。

Objective To analyze the effect of early application of recombinant human brain natriuretic peptide(rhBN) on prognosis and biochemical markers in patients with acute myocardial infarction(AMI).Method 83 patients with AMI treated in our hospital were selected and divided into observation group(41 cases) and control group(42 cases)according to the random number generated by computer.The patients were treated with antiplatelet and thrombolytic therapy,and the observation group was treated with rhBN at the same time.The changes of serum creatine kinase isoenzyme(CK-MB),N-terminal pro brain natriuretic pept ide(NT-proBNP) and cardiac troponin Ⅰ(cTnⅠ) levels at different time points before intervention,24 hours,48 hours and 72 hours of intervention were compared between the two groups,and they were followed up for 3 months to evaluate the prognosis of the two groups during the follow-up period.Results The levels of CK-MB,NT-Pro BNP and cTnI in the two groups at 24 h and 48 h after the intervention were significantly higher than those before the intervention,and the indexes of the observation group were lower than those of the control group,the difference was statistically significant(p>0.05).The total incidence of adverse events in the observat ion group was 17.07%,lower than 38.09% in the control group,which was statistically significant(P<0.05).Conclusion Early application of rhBN in patients with AMI can effectively improve myocardial function,avoid adverse events,and have a better prognosis.