重组人脑利钠肽对行直接介入治疗的急性心肌梗死患者心肾保护作用

摘要

Objective To study the protective effect of rhBNP on cardiac and renal function in AMI patients with ST-segment elevation undergoing primary PCI.Methods Ninety AMI patients with ST-segment elevation who underwent PCI were randomly divided into treatment group (n=44)and control group (n=46).Their infarction size and serum Cr and Cys-C levels were measured,their cardiac and renal functions were assessed,and the incidence of contrast-induced nephropathy (CIN) was recorded.Results The QRS score was significantly lower and the infarction size was significantly smaller in treatment group and control group on days 1 and 7 after PCI than before PCI (P＜0.05).The LVEDD was significantly shorter and the LVEF was significantly higher in treatment group on day 7 after PCI than before PCI (P＜0.05).The QRS score was significantly lower and the infarction size was significantly smaller in treatment group than in control group on days 1 and 7 after PCI while the LVEDD was significantly shorter and the LVEF was significantly higher in treatment group on day 7 after PCI (P＜0.05).The serum Cr and Cys-C levels were significantly higher in treatment group than in control group on day 1 after PCI and in control group on days 1 and 2 after PCI (P＜0.05) and were significantly lower in treatment group than in control group on days 2 and 3 after PCI (P＜0.05).The incidence of CIN was significantly lower in treatment group than in control group (4.5％ vs 19.6％,P＜0.05).Conclusion rhBNP can reduce the myocardial infarction size and the incidence of CIN,and protect the cardiac and renal function in AMI patients with ST-segment elevation.%目的 探讨重组人脑利钠肽对行直接PCI的急性前壁ST段抬高型心肌梗死患者心肾保护作用.方法 入选行直接PCI的急性前壁ST段抬高型心肌梗死患者90例,按照随机数字表法分为治疗组44例,对照组46例.观察2组患者心肌梗死面积、心功能指标、血清肌酐、胱抑素C、造影剂肾病发生率.结果 与治疗前比较,2组术后1、7 d QRS记分及心肌梗死面积明显降低,治疗组术后7d左心室舒张末内径(LVEDD)明显降低,LVEF明显升高(P＜0.05).与对照组比较,治疗组术后1、7 d QRS记分及心肌梗死面积明显降低;术后7 d LVEDD明显降低,LVEF明显升高(P＜0.05).与治疗前比较,治疗组术后1d肌酐和胱抑素C明显升高,对照组术后1、2d肌酐和胱抑素C明显升高(P＜0.05).与对照组比较,治疗组术后2、3d肌酐和胱抑素C明显降低(P＜0.05).治疗组造影剂肾病发生率明显低于对照组(4.5％ vs 19.6％,P＜0.05).结论 急性前壁ST段抬高型心肌梗死患者直接PCI前应用重组人脑利钠肽可减少心肌梗死面积,保护心功能,降低造影剂肾病发生率.