脑利钠肽在急诊经皮冠状动脉介入治疗急性心肌梗死患者预后评估中的作用

摘要

目的：观察脑利钠肽（BNP）在急诊经皮冠状动脉介入（PCI）治疗急性心肌梗死患者预后评估中的作用。方法：选取我院急诊科及心内科2013年7月－2014年12月收入的急性心肌梗死患者108例为研究对象，入院经心电图诊断为ST段抬高性心肌梗死（STEMI），并于发病12h内行急诊PCI治疗。结果：所有病例均于入院12h内顺利完成急诊PCI术，术中及术后未发生明显并发症。PCI术前BNP浓度为（586．4±153．7）ng／ml ，PCI术后24h BNP浓度为（390．4±126．3）ng／ml显著低于术前（P＜0．05），术后根据PCI浓度分为三组，A组17例，B组66例，C组25例，三组在年龄上存在显著差异，PIC 术后半年三组病例行超声心动图检查，C组的 LVEF显著低于B组与 A 组（ P＜0.05），B组LVEF显著低于A组（P＜0．05），B组与C组的LVEDV、LVESV显著高于A组（P＜0．05），对三组病例随访1年，A组死亡1例（5．9％），B组6例（9．1％），C组9例（36．0％）；C组病死率显著高于A组与B组，B组病死率显著高于A组（P＜0．05）。结论：急性心肌梗死患者行急诊经皮冠状动脉介入治疗后检测血浆BNP的浓度水平与梗死严重程度、心脏功能、左室重塑等情况有关，有利于对患者的再灌注恢复情况作出判断，对介入术后患者的预后具有评估价值。%Objective :To observe the brain natriuretic peptide in emergency percutaneous coronary intervention in pa‐tients with acute myocardial infarction the role of prognostic evaluation .Methods :Our hospital emergency department and heart from July 2013 to December 2014 ,with revenues of 108 cases of patients with acute myocardial infarction as the research object ,hospitalization by ecg diagnosis for st‐elevation myocardial infarction (STEMI) ,and at the onset of 12h adept emergency percutaneous coronary intervention (PCI) .Results:The three groups of cases in hospital smoothly within 12h emergency PCI ,intraoperative and postoperative without obvious complications .PCI for preoperative BNP concentration(586 .4 ± 153 .7)ng/ml ,PCI postoperative 24h BNP concentration for (390 .4 ± 126 .3)ng/ml was signifi‐cantly lower than preoperative BNP levels (P<0 .05) ,according to the concentration of PCI postoperative divided into 3 groups ,A group of 17 cases ,66 cases of group B ,group C 25 cases ,three sets of significant differences in age ,six months after PIC of three cases of echocardiography ,group C LVEF was significantly lower than group B and group A (P<0 .05) ,group B LVEF was significantly lower than that of group A (P<0 .05) ,group B and group C LVEDV , LVESV is significantly higher than group A (P<0 .05) .The three groups of cases were followed up for 1 year ,1 case of death was 5 .9% in group A of ,6 cases of group B 9 .1% ,9 cases of group C 36 .0% ;group C case fatality rate is sig‐nificantly higher than in group A and group B ,group B was significantly higher than that of group A (P<0 .05) .Con‐clusion:Patients with acute myocardial infarction underwent emergency percutaneous coronary interventional therapy after testing the concentration of plasma brain natriuretic peptide levels and severity infarction ,cardiac function and left ventricular remodeling ,and so on and so forth ,is conducive to reperfusion recovery of the patients with judgment ,to intervene in the prognosis of patients with postoperative evaluation value.