Objective To explore the effect of recombinant human brain natriuretic peptide ( rhBNP) on cardial remodeling after primary percutaneous coronary intervention ( p-PCI ) in patients with acute myocardial infarction .Methods Eighty-three patients with acute ST segment elevation myocardial infarction underwent p-PCI within 12 hours after attack , and were divided into treatment group (n=39) and control group(n=44).Control group was given routine therapy after p-PCI,while treatment group was administered intravenously rhBNP after p-PCI besides routine therapy.The plasma levels of brain natriuretic peptide(BNP) were detected in both groups before p-PCI,and echocardiography was conducted for the measurement of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume ( LVEDV) within 24 hours after p-PCI and after 6 months of p-PCI.The incidence of main adverse cardiovascular events ( MACE) within 6 months after p-PCI was recorded.Results There was no significant difference in the BNP level between two groups before p-PCI(P>0.05). For two groups ,LVEF increased and LVEDV decreased after 6 months of p-PCI compared to these indices within 24 hours after p-PCI (P<0.01).After 6 months of p-PCI,treatment group obtained higher LVEF and lower LVEDV compared to control group (P<0.05).The incidence of MACE of treatment group was lower than that of control group (P<0.05).Conclusion The application of rhBNP in early stage after p-PCI can improve the cardial remodeling of patients with acute myocardial infarction ,and has lower incidence of MACE .%目的:探讨急诊冠状动脉介入( p-PCI)术后应用重组人脑钠肽( rhBNP)对急性心肌梗死患者心室重构的影响。方法83例急性ST段抬高型心肌梗死患者于发病12 h内接受p-PCI,其中对照组44例术后给予常规治疗,治疗组39例术后常规治疗加静脉注射rhBNP。术前检测两组患者血浆人脑钠肽( BNP)水平;术后24 h内及6个月行超声心动图检测,测定左室射血分数( LVEF)、左心室舒张末期容积( LVEDV);记录术后6个月内不良心血管事件的发生率。结果两组术前BNP水平比较,差异无统计学意义(P>0.05)。与术后24 h内相比,两组术后6个月的LVEF增高、LVEDV降低(P<0.01);术后6个月,治疗组LVEF较对照组高 LVEDV 较对照组减低( P <0.05)。治疗组不良心血管事件的发生率低于对照组(P<0.05)。结论 p-PCI术后早期应用rhBNP可改善急性心肌梗死患者的心室重构,且不良心血管事件发生率较低。
展开▼