急性非ST段抬高心肌梗死患者不同治疗方式BNP变化及左心室重构分析

摘要

Objective To investigate the changes of the B - type natriuretic peptide ( BNP ) and left ventricle reconstitution in acute non - ST elevated myocardial infarction patients with different therapy . Methods A total of 104 cases of primary acute non - ST elevated myocardial infarction patients from February 2010 to August 2011 were selected. According to different treatments, the subjects were randomly divided into two groups: Percutaneous coronary artery intervention ( PCI ) treatment group ( n =54 ) and conservative drug treatment group ( n = 50 ). The changes of BNP, left ventricular end systolic volume( LVESV ) and left ventricular end - diastolic volume( LVEDV ) on admission and 4 weeks after infarction onset were observed. Results On admission, the BNP level had no difference between PCI treatment group and conservative medical treatment group ( P > 0. 05 ), but there were significant difference 4 weeks after infarction onset between the two groups ( P < 0. 05 ). LVESV and LVEDV had no significant difference between two groups at admission and 4 weeks after infarction onset. Conclusion Excluding the effect of the heart function, after different therapy, the average BNP level was significantly lower in PCI treatment group than that of conservative medicine therapy group. After a followed - up of four weeks,the index of left ventricle reconstitution had no statistical difference between the two groups.%目的 探讨急性非ST段抬高心肌梗死患者不同治疗方式B型尿钠肽(B-type natriuretic peptide,BNP)的变化及左心室重构情况.方法 选择2010年2月-2011年8月初发急性心肌梗死患者104例,根据不同的治疗方式分为经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)治疗组54例和药物非手术治疗组50例,观察入院时及发病后4周BNP、左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)和左心室收缩末期容积(left ventricular end systolic volume,LVESV)变化.结果 PCI治疗组与药物非手术治疗组入院时BNP值相比较差异无统计学意义(P＞0.05),发病4周后PCI治疗组BNP值明显低于药物非手术治疗组(P＜0.05).LVESV 及LVEDV 在入院时及发病4周后2组之间比较差异均无统计学意义.结论 在排除心功能的影响下,经过不同的治疗后,PCI治疗组平均BNP水平明显低于药物非手术治疗组,4周时随访左心室重构指标在2组之间差异无统计学意义.