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目的研究急性心肌梗死(AMI)患者接受急诊或择期经皮冠状动脉介入治疗(PCI)后血浆氨基末端脑钠肽前体(NT-proBNP)变化及其与心功能、心血管事件的关系。方法 2009年7月～2010年12月,发病后12 h内接受急诊PCI治疗的ST段抬高AMI患者为A组(n=46例),住院期间行择期PCI治疗者为B组(n=42),发病后24小时内入院的AMI患者未行再灌注治疗者为C组(n=34);测量NT-proBNP,完善心脏彩超检查,记录三组患者半年内的心血管事件。结果 A组NT-proBNP在入院后较B、C组明显下降,B组NT-proBNP在心肌梗死第11天及以后较C组明显下降;心功能方面:A、B组,A、C组及B、C组在第45天及半年时差异明显;A、B、C三组心血管事件组间差异明显;上述差异有统计学意义(p<0.05)。结论AMI患者行急诊或择期PCI后NT-proBNP明显下降,能降低心血管事件,但急诊PCI优于择期PCI治疗;同时NT-proBNP水平可作为患者心功能预测因子。
Objective To investigate the changes of plasma NT-proBNP level after acute or selective percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and its relationship with cardiac function and cardiovascular events. Methods From July 2009 to December 2010, patients with ST-segment elevation AMI who received emergency PCI within 12 hours after onset were Group A (n = 46) and patients undergoing elective PCI during the hospitalization period were Group B (n = 42). AMI patients admitted within 24 hours after onset were treated with no reperfusion therapy in group C (n = 34). NT-proBNP was measured and cardiac echocardiography was performed. Cardiovascular events within three months were recorded in three groups. Results NT-proBNP in group A was significantly lower than that in group B and C after admission. The NT-proBNP in group B was significantly lower than that in group C on the 11th day and after myocardial infarction in group A. In terms of cardiac function, group A, B, A and C, There was significant difference between group B and C on the 45th day and the half year. There was significant difference between the three groups of A, B and C cardiovascular events; the difference was statistically significant (p <0.05). Conclusions NT-proBNP significantly decreased after emergency or elective PCI in patients with AMI, which could reduce cardiovascular events. However, emergency PCI was superior to elective PCI, and NT-proBNP level could be used as a predictor of cardiac function.