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目的:探讨急性心肌梗死(AMI)早期脑钠肽(BNP)水平与左室重构及预后的关系。方法:用放射免疫法测定AMI患者早期血浆BNP水平;用超声心动图检查测量左室收缩末容积(ESV)、左室舒张末容积(EDV)、射血分数(EF)并通过计算得左室质量(LVM)。并根据左心室容积指标分组,左心室容积增加率>20%为左心室重构组,否则为非重构组,比较两组血浆BNP水平。结果:重构组恢复期左心室舒张末期及收缩末期容积指数均高于非重构组(P<0.01),亦高于急性期左心室容积(P<0.01)。重构组早期血浆BNP浓度明显高于非重构组(P<0.01),恢复期也较非重构组高(P<0.01)。重构组早期BNP浓度与恢复期左心室容积及容积变化量之问呈正相关。结论:AMI早期BNP升高与急性期左室重构密切相关,血浆BNP浓度可以作为溶栓治疗再通的观察指标及预后判断依据。
Objective: To investigate the relationship between early brain natriuretic peptide (BNP) levels and left ventricular remodeling and prognosis in patients with acute myocardial infarction (AMI). Methods: The levels of plasma BNP in AMI patients were measured by radioimmunoassay. The left ventricular end-systolic volume (ESV), left ventricular end-diastolic volume (EDV) and ejection fraction (EF) were measured by echocardiography. Quality (LVM). The left ventricular volume was increased by> 20% in left ventricular remodeling group, otherwise non-remodeling group. Plasma BNP levels were compared between the two groups. Results: The LV end-diastolic volume and end-systolic volume index of reconstructive group were higher than that of non-reconstructed group (P <0.01), and higher than that of acute phase (P <0.01). The plasma BNP concentration in the remodeling group was significantly higher than that in the non-remodeling group (P <0.01), and the recovery time was also higher than that in the non-remodeling group (P <0.01). There was a positive correlation between early BNP concentration in remodeling group and left ventricular volume and volume change during convalescence. Conclusion: The elevated BNP in early AMI is closely related to acute left ventricular remodeling. Plasma BNP concentration can be used as the re-pass of thrombolytic therapy and prognostic criteria.