干预性急性心肌梗死158例血浆B型钠尿肽急诊PCI术后的表达变化与临床意义(1)
【摘要】 目的：探讨干预性急性心肌梗死患者行急诊经皮冠状动脉介入术(PCI)后血浆B型钠尿肽的水平变化及其临床意义。方法：将本院2009年3月-2013年3月收治的316例急性心肌梗死患者按照随机数字表法分为观察组和对照组，每组158例。观察组患者于发病12 h内行急诊PCI，对照组患者未行急诊PCI只作常规治疗。比较分析两组患者入院时及入院后第1、7、30天的血浆BNP水平变化，测定患者入院时的血清CK-MB、肌钙蛋白I(cTnI)、MYO等心肌损伤指标，以及入院前、后左心室射血分数(LVEF)、左心室舒张末期容积指数(LVEDVI)和左室收缩末期容积指数(LVESVI)，并随访6个月，观察不良心血管事件发生情况。结果：两组患者入院时血清CK-MB、cTnI、MYO、血浆BNP、LVEDVI、LVESVI及LVEF等指标比较差异均无统计学意义(P>0.05)；入院7 d后，观察组患者BNP浓度显著低于入院时(P<0.01)，对照组患者BNP浓度显著高于入院时(P<0.01)；30 d后，两组患者血浆BNP浓度与入院时比较均显著降低(P<0.01)。同时，入院7、30 d时，观察组的血浆BNP浓度、LVEDVI、LVESVI及LVEF水平均显著低于对照组，差异均有统计学意义(P<0.01)；随访6个月后，观察组患者MACE发生率18.35%(29/158)显著低于对照组的34.18%(54/158)，比较差异有统计学意义( 字2=10.2125，P<0.01)；血浆BNP水平与血清CK-MB、cTnI、MYO、LVEDVI、LVESVI、MACE呈正相关(P<0.01)，与LVEF呈负相关(P<0.01)。结论：血浆BNP的表达水平可以有效评估急性心肌梗死患者经急诊PCI术后的疗效及预后。
, 百拇医药
【关键词】 急性心肌梗死； B型钠尿肽； 急诊PCI； 预后； 临床意义
The Expression Changes and Clinical Significance of the Plasma B-type Natriuretic Peptide of 158 Patients with Intrusive Acute Myocardial Infarction after Emergency PCI Surgery/HE Bing.//Medical Innovation of China，2015，12(26)：011-014
【Abstract】 Objective：To investigate the changes and clinical significance of plasma B-type natriuretic peptide level in patients with intrusive acute myocardial infarction after emergency percutaneous coronary intervention.Method：316 patients with acute myocardial infarction admitted to our hospital from March 2009 to March 2013 were divided into the observation group and the control group according to the random number table method，158 cases in each group.The observation group was treated with emergency PCI within 12 hours of onset，the control group was only given conventional therapy without emergency PCI.The plasma BNP level changes of the two groups on admission and 1 day，7 and 30 days after admission were compared and analyzed，the myocardial damage index such as serum CK-MB，troponin I(cTnI) and MYO of the two groups were determined.The left ventricular ejection fraction(LVEF)，left ventricular end-diastolic volume index(LVEDVI) and left ventricular end systolic volume index(LVESVI)，after 6 months of follow-up，the occurrence of adverse cardiovascular events were observed.Result：There were no significance differences in the levels of CK-MB，cTnI，MYO，plasma BNP，LVEDVI，LVESVI and LVEF between the two groups on admission(P>0.05).Compared with on admission，the BNP concentration of observation group decreased but that in the control group increased 7 days after admission，the differences were statistically significant(P<0.01).30 days after admission，the BNP concentration of the two groups were significantly lower than on admission(P<0.01).Besides，the level of plasma BNP，LVEDVI，LVESVI and LVEF in the observation group were significantly lower than those of the control group 7 and 30 days after admission，the differences were statistically significant(P<0.01).Postoperative follow-up of 6 months，the incidence of major adverse cardiovascular events(MACE) in the observation group was 18.35%(29/158)，which was significantly lower than 34.18%(54/158) in the control group，the difference was statistically significant( 字2=10.2125，P<0.01).The BNP had positive correlation with CK-MB，cTnI，MYO，LVEDVI，LVESVI and MACE(P<0.01)，and negatively related with LVEF(P<0.01).Conclusion：Plasma BNP can serve as a predictor of acute myocardial infarction after emergency percutaneous coronary intervention，it is also a valuable index for prognosis monitoring and curative effect., 百拇医药(何冰)
, 百拇医药
【关键词】 急性心肌梗死； B型钠尿肽； 急诊PCI； 预后； 临床意义
The Expression Changes and Clinical Significance of the Plasma B-type Natriuretic Peptide of 158 Patients with Intrusive Acute Myocardial Infarction after Emergency PCI Surgery/HE Bing.//Medical Innovation of China，2015，12(26)：011-014
【Abstract】 Objective：To investigate the changes and clinical significance of plasma B-type natriuretic peptide level in patients with intrusive acute myocardial infarction after emergency percutaneous coronary intervention.Method：316 patients with acute myocardial infarction admitted to our hospital from March 2009 to March 2013 were divided into the observation group and the control group according to the random number table method，158 cases in each group.The observation group was treated with emergency PCI within 12 hours of onset，the control group was only given conventional therapy without emergency PCI.The plasma BNP level changes of the two groups on admission and 1 day，7 and 30 days after admission were compared and analyzed，the myocardial damage index such as serum CK-MB，troponin I(cTnI) and MYO of the two groups were determined.The left ventricular ejection fraction(LVEF)，left ventricular end-diastolic volume index(LVEDVI) and left ventricular end systolic volume index(LVESVI)，after 6 months of follow-up，the occurrence of adverse cardiovascular events were observed.Result：There were no significance differences in the levels of CK-MB，cTnI，MYO，plasma BNP，LVEDVI，LVESVI and LVEF between the two groups on admission(P>0.05).Compared with on admission，the BNP concentration of observation group decreased but that in the control group increased 7 days after admission，the differences were statistically significant(P<0.01).30 days after admission，the BNP concentration of the two groups were significantly lower than on admission(P<0.01).Besides，the level of plasma BNP，LVEDVI，LVESVI and LVEF in the observation group were significantly lower than those of the control group 7 and 30 days after admission，the differences were statistically significant(P<0.01).Postoperative follow-up of 6 months，the incidence of major adverse cardiovascular events(MACE) in the observation group was 18.35%(29/158)，which was significantly lower than 34.18%(54/158) in the control group，the difference was statistically significant( 字2=10.2125，P<0.01).The BNP had positive correlation with CK-MB，cTnI，MYO，LVEDVI，LVESVI and MACE(P<0.01)，and negatively related with LVEF(P<0.01).Conclusion：Plasma BNP can serve as a predictor of acute myocardial infarction after emergency percutaneous coronary intervention，it is also a valuable index for prognosis monitoring and curative effect., 百拇医药(何冰)