PCI术后早期应用重组人脑利钠肽对心脏左室功能临床价值探究

Clinical value of recombinant human brain natriuretic peptide on left ventricular function after PCI

目的:探究急性心肌梗死患者PCI术后早期应用重组人脑利尿肽(rhBNP)对左室功能和预后的影响。方法:选取2017年1月~2017年4月我院心血管内科收治的急性心肌梗死行PCI术的80例患者,采用随机数字法分为实验组和对照组,每组40例,对照组术后接受冠心病常规治疗,实验组在常规治疗基础上加用rhBNP治疗,于术后1h开始。对比两组患者术前、术后24h、术后48h和术后72h cTNI及NT-proBNP水平;对比术前、出院前以及出院后1个月两组患者左室舒张末内径(LVEDd)和左室射血分数(LVEF)变化;患者出院前根据Killip分级判定并比较两组患者心功能改善情况;比较两组患者3个月内不良心血管事件(MACE)发生率。结果:术后48h和术后72h,实验组患者cTNI和NT-proBNP水平明显低于对照组,差异有统计学意义;出院后1个月,实验组患者LVEDd低于对照组、LVEF高于对照组,差异有统计学意义;出院1个月后,实验组和对照组总有效率分别为85.0%和57.7%,差异有统计学意义;出院3个月后,实验组和对照组MACE发生率分别为12.5%和27.5%,差异有统计学意义。结论:心肌梗死患者PCI术后早期应用rhBNP可改善患者心脏左室功能、降低不良心血管事件发生率、改善预后。

Objective To investigate the effect of recombinant human brain natriuretic peptide(rhBNP) on left ventricular function and prognosis in patients with acute myocardial infarction after PCI. Methods 80 cases from January 2017 to April 2017 in our hospital of cardiovascular medicine treated acute myocardial infarction underwent PCI surgery were divided into experimental group and control group randomly, 40 cases in each group, the control group received postoperative conventional treatment of coronary heart disease, the experimental group was treated with rhBNP on the basis of routine treatment, at 1 h after operation. Start. Comparison of two groups of patients with preoperative and postoperative 24 h, 48 h and 72 h after cTNI and NTproBNP; compared with preoperative, before discharge and 1 months after discharge in two groups of patients with left ventricular end diastolic diameter(LVEDd) and left ventricular ejection fraction(LVEF) changes in patients before discharge; according to the Killip grading the two groups were compared in the improvement of cardiac function; compared two groups of patients within 3 months of adverse cardiovascular events(MACE) occurrence rate. Results Postoperative 48 h and postoperative 72 h, cTNI and NT-proBNP levels of patients in the experimental group was significantly lower than the control group, the difference was statistically significant; 1 months after discharge, patients in the experimental group than in the control group LVEDd, LVEF higher than the control group, the difference was statistically significant; out of school after 1 months the experimental group and the control group total effective rate were 85% and 57.7%, the difference was statistically significant; 3 months after discharge, the experimental group and the control group the incidence rate of MACE were 12.5% and 27.5%, the difference was statistically significant. Conclusion The early application of rhBNP in patients with myocardial infarction after PCI can improve the left ventricular function, reduce the incidence of adverse cardiovascular events and improve prognosis.