再灌注治疗对急性心肌梗死患者血浆脑钠尿肽和左心室重塑的影响
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The Effects of Early Reperfusion Therapy on Plasma Brain Natriuretic Peptide Levels and Left Ventricular Remodeling in Patients with Acute Myocardial Infarction
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    摘要:

    探讨再灌注治疗对急性心肌梗死患者血浆脑钠尿肽水平和左心室重塑的影响。选择急性心肌梗死患者5 6例,胸痛发作12h内成功再灌注者38例为再灌注组,再灌注失败或未进行再灌注者18例为非再灌注组。酶联免疫吸附法测定入院即刻、2 4h、4 8h、7天、14天及2 8天时血浆脑钠尿肽水平;入院后3~5天、2 8天超声心动图测量左心室舒张末期容积指数、左心室收缩末期容积指数和左心室射血分数,并计算它们的变化量。结果发现,急性心肌梗死患者血浆脑钠尿肽水平较正常人明显升高;再灌注组血浆脑钠尿肽水平呈单峰曲线,非再灌注组呈双峰曲线;再灌注治疗可明显降低急性心肌梗死患者脑钠尿肽水平,其第7天时浓度升高不明显,未形成第2个高峰。再灌注可减少左心室容积增加并提高左心室射血分数。结果提示,早期再灌注可明显降低血浆脑钠尿肽水平并减轻左心室重塑。

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    Aim To investigate the effect of reperfusion therapy on plasma brain natriuretic peptide (BNP) levels and left ventricular remodeling (LVRM) in patients with acute myocardial infarction (AMI). Methods The study group included 56 patients with acute myocardial infarction (AMI), 38 patients undergone successful early reperfusion therapy as the reperfusion group, 18 patients undergone non-successful or rejected reperfusion therapy as the non-reperfusion group. Peripheral blood samples were taken at admission, on 24 hours, 48 hours, day 7, day 14, and day 28 after admission for BNP measurement by ELISA. The indexes of LVRM include left ventricular end diastolic volume index (LVEDVI), left ventricular end systolic volume index (LVESVI) and left ventricular eject fraction (LVEF) were measured by ultrasonic cardiogram on day 3~5 and day 28. △LVEDVI, △LVESVI and △LVEF were obtained by subtracting values of day 3~5 from which of day 28. Results Plasma BNP levels in patients with AMI were higher than those in health. In reperfusion group only one peak of BNP values was detected on 24 hours after admission, but two peaks of BNP values were detected in non-reperfusion group, the first peak on 24 hours and secondary peak on day 7 after admission. The reperfusion therapy can attenuate the enlarge of LVEDVI, LVESVI and improve LVEF. Conclusion The reperfusion therapy can decrease BNP levels , attenuate LVRM and improve LVEF.

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杨海波,唐元升,朱兴雷,黄振文.再灌注治疗对急性心肌梗死患者血浆脑钠尿肽和左心室重塑的影响[J].中国动脉硬化杂志,2004,12(6):687~689.

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  • 收稿日期:2004-01-18
  • 最后修改日期:2004-07-04
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