磷酸肌酸钠联合冻干重组人脑利钠肽对急性ST段抬高型心肌梗死患者心电图及血清MMP­9NT­proBN P水平的影响△

摘要

目的 探讨注射用磷酸肌酸钠联合冻干重组人脑利钠肽对急性ST 段抬高型心肌梗死患者心电图及血清N末端B型钠尿肽原、基质金属蛋白酶-9水平的影响.方法 将96例急性ST段抬高型心肌梗死患者按随机数字表法分为两组,各48例.对照组采用常规治疗,在此基础上观察组采用注射用磷酸肌酸钠联合冻干重组人脑利钠肽治疗,观察2周,随访1个月,比较治疗前后两组心功能、尿量、呼吸困难评分,检测血清 N末端B型钠尿肽原、基质金属蛋白酶-9水平及心电图变化,统计不良心血管事件发生情况.结果 (1)观察组治疗总有效率为89 .6%,对照组为70 .83%,观察组显著高于对照组( P＜0 .05) ;(2)治疗后观察组左心室舒张末期内径、左心室收缩末期内径值显著低于对照组(P＜ 0 .01) ,左心室射血分数显著高于对照组(P＜0 .01) ;(3)治疗后观察组血清 N末端B型钠尿肽原、基质金属蛋白酶-9水平显著低于对照组(P＜0 .01) ;(4)治疗后观察组尿量显著多于对照组,呼吸困难评分显著低于对照组(P＜0 .01) ;(5)随访1个月,观察组不良心血管事件发生率为6 .2%,对照组为22 .9%,观察组显著低于对照组(P＜0 .05) .结论 注射用磷酸肌酸钠联合冻干重组人脑利钠肽治疗急性ST 段抬高型心肌梗死临床疗效显著,可明显改善患者心电图及心功能,降低血清N末端B型钠尿肽原、基质金属蛋白酶-9水平及不良心血管事件发生率.%Objective To investigate the effect of creatine phosphate sodium combined with lyophiluzed re- com binant human brain natriuretic peptide on ECG and serum M M P-9 ,N T-proBN P levels in patients w ith acute ST-segment elevation myocardial infarction .Methods 96 patients with acute ST-segment elevation myocardial infarction w ere divided into tw o groups according to the random num ber table ,48 cases each . T he control group w as treated w ith conventional therapy .On the basis of this ,the observation group w as treated w ith creatine phosphate sodium for injection com bined w ith lyophiluzed reco mbinant human brain natriuretic peptide .Bo th g roups w ere observed for 14 d ,follow ed up for 1 month .Cardiac function ,urine volume ,and dyspnea score of the tw o groups w ere co mpared before and af ter treatment , T he changes of N T-proBN P ,M M P-9 levels and ECG w ere detected ,and the incidence of adverse cardiovascular events was count .Results (1) ECG efficacy :The total effective rate of treatment group (89 .58%) was higher than that of the control g roup (70 .83%)( P＜ 0 .05 ) ; (2 ) Cardiac function :Compared w ith the control group ,the LVSd and LVDd values w ere low er and the L VEF w as higher af ter treatment ( P＜0 .01) ;(3) T he levels of serum N T-proBNP and M M P-9 in the observation group w ere lower than those in the control group (P＜0 .01) ;(4) Compared with the control group ,the urine volume in the observation g roup w as higher and the dyspnea score w as low er ( P＜0 .05) ;(5) Af ter 1 month follow-up ,the incidence of adverse cardiovascular events in the observation group (6 .2%) w as low er than that in the control group (22 .9%) ( P＜0 .05).Conclusion Creatine phosphate sodium for injection co mbined w ith lyophilized re- com binant human brain natriuretic peptide for S T EM I can improve ECG and cardiac function ,and reduce serum N T-proBN P ,M M P-9 levels and adverse cardiovascular events ,w ith significant clinical efficacy .