Objective To analyze the influence of recombinant human brain natriuretic peptide (rhBNP) on ventricular remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI).Methods STEMI patients (n=88, male 73 and female 15) were chosen from the Affiliated Hospital of Hebei University from Mar. 2014 to May 2016. All patients were randomly divided into rhBNP group (n=42) and control group (n=46). There were 3 cases missed in rhBNP group and 2 missed in control group, and finally there were 39 cases in rhBNP group and 44 in control group. All patients in 2 groups were given routine drugs and PCI within 12 h after STEMI onset, and rhBNP group was intravenously given rhBNP. The indexes of left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were detected after PCI for 12 h and 6 m, and △LVEDV% was calculated and △LVEDV≥15% was defined as ventricular remodeling. The patients were followed up for 6 m for recording major adverse cardiovascular events (MACE).Results The value of LVEF was improved after PCI for 6 m compared with that after PCI for 12 h, which was more significant in rhBNP group compared with control group [(54.92±3.78)%vs. (52.77±2.90)%, all P<0.05]. The value of LVEDV decreased in rhBNP group compared with control group after PCI for 6 m (P<0.05). There were 2 patients (5.1%) with left ventricular remodeling in rhBNP group and 15 (34.1%) in control group after PCI for 6 m (P<0.05). After followed up for 6 m, there were 4 patients (10.3%) with rhBNP group and 14 (31.8%) in control group (P<0.05).Conclusion The early application of rhBNP after Emergency PCI can relieve ventricular remodeling and reduce incidence of MACE in patients acute STEMI.%目的 分析重组人脑钠肽(rhBNP)对急性ST段抬高型心肌梗死(STEMI)患者行急诊冠状动脉介入治疗(PCI)后心室重构的影响.方法 选取2014年3月~2016年5月期间于河北大学附属医院治疗的STEMI患者88例,其中男性73例,女性15例.所有患者随机分为rhBNP组(42例)与对照组(46例).rhBNP组失访3例,对照组失访2例,最终纳入rhBNP组(39例)和对照组(44例).两组患者均给予常规药物治疗,并于发病12 h内行PCI,rhBNP组术后静脉给予rhBNP.术后12 h内及6个月采用超声心动图测定左室舒张末期容积(LVEDV)、左室射血分数(LVEF),并计算左室舒张末期容积增长率(△LVEDV%),以△LVEDV≥15%定义为心室重构.术后随访6个月,记录主要不良心血管事件.结果 两组术后6个月的LVEF值较术后12 h内的测量值改善,rhBNP组较对照组改善更明显,[(54.92±3.78)%vs.(52.77±2.90)%],差异有统计学意义(P均<0.05).术后6个月,rhBNP组较对照组LVEDV测量值降低,差异有统计学意义(P<0.05).术后6个月时,rhBNP组左室重构2例(5.1%),对照组15例(34.1%),rhBNP组明显低于对照组,差异有统计学意义(P<0.05).随访6个月,rhBNP组主要不良心血管事件发生4例(10.3%),明显低于对照组的14例(31.8%),差异有统计学意义(P<0.05).结论 急性STEMI患者急诊介入治疗术后早期应用rhBNP可改善心室重构,且主要不良心血管事件发生率较低.
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