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目的:通过测定不同血糖状态下急性心肌梗死(AMI)患者溶栓后血清脑钠素(BNP)水平的变化,以探讨不同血糖状态下AMI患者溶栓后心功能及预后的情况。方法:测定入选107例患者入院后次日及第7天空腹血清BNP,发病第7天检测OGTT,并按OGTT结果将患者分为血糖正常(NGT)组,糖耐量异常(IGT)组和糖尿病(DM)组,同期检测左室射血分数(LVEF)及肌酸激酶同工酶(CK-MB)动态变化以及心功能情况,梗死后心绞痛、心律失常(室性心动过速、心室颤动、Ⅲ度房室传导阻滞)发生率。结果:DM组入院次日及第7天血清BNP水平与NGT组比较均差异有统计学意义(P<0.01),IGT组第7天血清BNP水平与NGT组差异有统计学意义(P<0.01)。3组间LVEF及CK-MB差异无统计学意义。结论:AMI患者溶栓后不同血糖状态的患者心功能受损及预后均有不同,DM者及IGT者心脏受损更重。检测不同血糖状态下血清BNP水平能较好评价溶栓后AMI患者心功能及预后。
Objective: To investigate the changes of serum brain natriuretic peptide (BNP) levels after thrombolysis in patients with acute myocardial infarction (AMI) under different blood glucose levels to investigate the cardiac function and prognosis after thrombolysis in patients with AMI under different blood glucose levels. Methods: Fasting serum BNP was measured in 107 patients on the following day and on the 7th day after admission. OGTT was detected on the 7th day after the onset of the disease. According to OGTT results, the patients were divided into two groups: normal glucose tolerance group (IGT), diabetes mellitus group (DM) group. The changes of left ventricular ejection fraction (LVEF) and creatine kinase (CK-MB) and cardiac function, angina pectoris, arrhythmia (ventricular tachycardia, Ⅲ degree atrioventricular block) incidence. Results: There was significant difference in serum BNP level between the DM group and the NGT group on the next day and on the 7th day after admission (P <0.01), and there was a significant difference between the BNT level on the 7th day and the NGT group ). There was no significant difference in LVEF and CK-MB between the three groups. Conclusion: Patients with AMI have different impaired cardiac function and prognosis in patients with different blood glucose levels after thrombolysis, and those with DM and IGT have more severe heart damage. Detecting serum BNP levels in different blood glucose levels can be a better evaluation of cardiac function and prognosis in patients with AMI after thrombolysis.