冠脉介入对急性心肌梗死患者血浆BNP水平变化及心室重塑作用的影响分析(1)
【摘 要】目的：探讨冠脉介入对急性心肌梗死患者血浆BNP水平变化及心室重塑作用的影响。方法：选取从2017年4月—2018年4月进行治疗的120例心肌梗死患者为研究对象，随机分为研究组和对照组各60例，对照组采取常规药物治疗，研究组给予冠脉介入手术治疗，比较两组患者治疗前后BNP水平、心脏多普勒超声结果以及CK、CK-MB峰值水平。结果：两组患者治疗前及治疗后第二天BNP水平比较，差异无统计学意义(P>0.05)；两组患者治疗后第三天及治疗后第七天，研究组BNP水平明显低于对照组(P<0.05)。两组患者治疗前，超声结果LVEF、EDV、ESV水平比较，差异无统计学意义(P>0.05)；两组患者分别经不同方法治疗后，EDV、ESV水平均显著下降，LEVF水平均显著升高(P<0.05)。治疗后，相较于对照组，研究组EDV、ESV水平下降幅度更大，研究组LVEF水平升高幅度更大(P<0.05)。两组患者中，研究组的CK、CK-MB峰值水平高于对照组，差异无统计学意义(P>0.05)。结论：冠脉介入能有效降低患者血浆BNP水平，减缓心室重构，降低患者死亡率。
【关键词】冠脉介入；急性心肌梗死；血浆BNP
[Abstract] Objective：To discuss influences of coronary artery intervention on plasma BNP changes and ventricular remodeling of patients with acute myocardial infarction.Methods ：120patients with acute myocardial infarction treated from April2017to April208were selected as research objects and divided into the research group and control group(including60patients in each group.Patients in the control group applied the conventional drug， while patients in the research group accepted coronary artery intervention.BNP level， cardiac Doppler ultrasound results， CK， and CK-MB peak level of patients in both groups before and after treatment were compared.Results： BNP of patients in both groups before treatment and after second day of treatment had no statistical difference(P>0.05).BNP in the research group after third day of treatment and seventh day of treatment was significantly lower than the control group(P<0.05).Before treatment， ultrasound LVEF， EDV and ESV in both groups had no statistical difference(P>0.05).After patients in both groups were treated with different methods， EDV and ESV were significantly reduced， while LEVF was significantly increased(P<0.05).After treatment， relative to the control group， EDV and ESV in the research group had the larger reduction amplitude， while LVEF in the research group had the larger rising amplitude(P<0.05).CK and CK-MB peak level in the research group were significantly higher than the control group.There was no statistical difference(P>0.05).Conclusions： Coronary artery intervention can effectively reduce patients’ plasma BNP， mitigate the ventricular remodeling and reduce patients’ morality
[Key words] Coronary artery intervention； acute myocardial infarction； plasma BNP
【中图分类号】R541.4 【文献标识码】A 【文章编号】2095-6851(2018)08--01
心肌梗死是指心肌的缺血性坏死，其主要特點为发病快，伴有剧烈而持久的胸骨后疼痛，可迅速发展为心律失常、心力衰竭甚至休克等疾病，危及生命。心肌梗死在欧美国家最为常见，但近年来，我国心肌梗死的发病率呈上升趋势，其主要病因为冠状动脉粥样硬化，某些诱因诱导下，动脉粥样硬化斑块破裂，形成血栓阻塞血管，从而导致心肌缺血坏死[1]。BNP是心肌细胞合成的一种激素类物质，可作为心力衰竭严重程度的判断指标，对于心肌梗死患者病情的预估有极大的实用价值。研究表明[2]，心室重塑是心肌梗死患者发生心力衰竭导致死亡的主要原因。因此，有效减轻心室重塑是降低心肌梗死患者死亡率的关键。心脏彩色超声多普勒检查是检查心功能指标的重要方法。目前，冠脉介入已成为治疗心肌梗死的有效方法，其通过介入手术，能及时抢救心肌缺血细胞，减少心室重塑，明显改善预后，降低死亡率。因此，本文主要探讨冠脉介入对急性心肌梗死患者血浆BNP水平变化及心室重塑作用的影响。 (杨齐)
【关键词】冠脉介入；急性心肌梗死；血浆BNP
[Abstract] Objective：To discuss influences of coronary artery intervention on plasma BNP changes and ventricular remodeling of patients with acute myocardial infarction.Methods ：120patients with acute myocardial infarction treated from April2017to April208were selected as research objects and divided into the research group and control group(including60patients in each group.Patients in the control group applied the conventional drug， while patients in the research group accepted coronary artery intervention.BNP level， cardiac Doppler ultrasound results， CK， and CK-MB peak level of patients in both groups before and after treatment were compared.Results： BNP of patients in both groups before treatment and after second day of treatment had no statistical difference(P>0.05).BNP in the research group after third day of treatment and seventh day of treatment was significantly lower than the control group(P<0.05).Before treatment， ultrasound LVEF， EDV and ESV in both groups had no statistical difference(P>0.05).After patients in both groups were treated with different methods， EDV and ESV were significantly reduced， while LEVF was significantly increased(P<0.05).After treatment， relative to the control group， EDV and ESV in the research group had the larger reduction amplitude， while LVEF in the research group had the larger rising amplitude(P<0.05).CK and CK-MB peak level in the research group were significantly higher than the control group.There was no statistical difference(P>0.05).Conclusions： Coronary artery intervention can effectively reduce patients’ plasma BNP， mitigate the ventricular remodeling and reduce patients’ morality
[Key words] Coronary artery intervention； acute myocardial infarction； plasma BNP
【中图分类号】R541.4 【文献标识码】A 【文章编号】2095-6851(2018)08--01
心肌梗死是指心肌的缺血性坏死，其主要特點为发病快，伴有剧烈而持久的胸骨后疼痛，可迅速发展为心律失常、心力衰竭甚至休克等疾病，危及生命。心肌梗死在欧美国家最为常见，但近年来，我国心肌梗死的发病率呈上升趋势，其主要病因为冠状动脉粥样硬化，某些诱因诱导下，动脉粥样硬化斑块破裂，形成血栓阻塞血管，从而导致心肌缺血坏死[1]。BNP是心肌细胞合成的一种激素类物质，可作为心力衰竭严重程度的判断指标，对于心肌梗死患者病情的预估有极大的实用价值。研究表明[2]，心室重塑是心肌梗死患者发生心力衰竭导致死亡的主要原因。因此，有效减轻心室重塑是降低心肌梗死患者死亡率的关键。心脏彩色超声多普勒检查是检查心功能指标的重要方法。目前，冠脉介入已成为治疗心肌梗死的有效方法，其通过介入手术，能及时抢救心肌缺血细胞，减少心室重塑，明显改善预后，降低死亡率。因此，本文主要探讨冠脉介入对急性心肌梗死患者血浆BNP水平变化及心室重塑作用的影响。 (杨齐)