急性ST段抬高型心肌梗死介入治疗对脑利钠肽及心室重构的影响

摘要

Objective To study the effects of percutaneous coronary intervention (PCI) on brain natriuretic peptide (BNP) and ventricular remodeling in patients with ST elevation myocardial infarction (STEMI). Methods Ninety-six patients with STEMI were divided into the observation group (n=47) and the control group (n=49), and the observation group were given primary PCI, while the control group were given elective PCI. BNP and ventricular remodeling were compared between the two groups, and the short-term prognosis were observed. Results There was no significantly difference in BNP, LVEDd and LVEF between the two groups before PCI, but BNP, LVEDd were significantly reduced after PCI (P<0.01 or P<0.05), and LVEF was significantly increased (P<0.01), and the observation group were significantly better than the control group after PCI (P<0.01). There was no significant difference in cardiac mortality between the two groups. Conclusion PCI has reliable efficacy in patients with STEMI, the BNP and the ventricular remodeling changed significantly in patients accepted primary PCI, but there is no significantly effect of the timing of PCI on the short-term prognosis.%目的 探讨经皮冠状动脉介入术治疗急性ST段抬高型心肌梗死(STEMI)对患者脑利钠肽及心室 重构的影响.方法 96 例急性STEMI患者根据经皮冠状动脉介入术(PCI)时机的不同分为观察组(n=47)与对照 组(n=49),观察组给予直接PCI,对照组给予择期PCI,比较两组患者脑利钠肽(BNP)水平及左心室重构情况,同时 观察两组患者近期预后.结果 PCI 术前两组BNP水平差异无统计学意义(P>0.05),术后两组BNP均显著降低 (P<0.05),且观察组术后显著低于对照组(P<0.01);术前两组LVEDd及LVEF均差异无统计学意义(P>0.05),术后 两组患者LVEDd显著降低(P<0.01),LVEF显著增高(P<0.01),且术后观察组显著优于对照组(P<0.01);随访6 个 月两组心源性死亡率比较差异无统计学意义(P>0.05).结论 PCI术对STEMI疗效可靠,在直接PCI术患者中心 室重构的改善及BNP水平的下降较为明显,但直接PCI或择期PCI对于患者近期预后无明显影响.