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目的:观察B型脑钠尿肽前体N末端(NT-proBNP)在急性心肌梗死(AM I)患者的变化。方法:应用电化学发光-夹心免疫分析法检测26例首次发生的ST段抬高型透壁性心肌梗死患者的血NT-proBNP,分析其与肌酸激酶MB同工酶、梗死部位和心功能的关系。对照组采用经临床和超声心动图检查无心脏结构和功能异常或其它伴随疾病的轻度高血压或稳定劳力性心绞痛患者22例。结果:AM I患者血NT-proBNP显著高于正常心功能对照组(2097±2008 ng/Lvs70±51 ng/L,P<0.01)。心功能≥Ⅱ级组血NT-proBNP显著高于心功能Ⅰ级组,分别为3172.6±2448.9 ng/L和1175±710.0 ng/L(P<0.01)。NT-proBNP与K illip分级呈正相关。结论:AM I后心脏钠尿肽系统激活,其改变与心功能分级有关,但无心室功能障碍和心房压升高者亦显著升高。
Objective: To observe the changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with acute myocardial infarction (AMI). Methods: The levels of NT-proBNP in 26 patients with first-stage ST-segment elevation transmural myocardial infarction were detected by electrochemiluminescence-sandwich immunoassay. The levels of creatine kinase MB isoenzyme, infarct site and cardiac function Relationship. The control group used clinical and echocardiographic examination of 22 patients with mild hypertension or stable angina pectoris without cardiac structure and function abnormalities or other accompanying diseases. Results: The level of NT-proBNP in patients with AM I was significantly higher than that in patients with normal cardiac function (2097 ± 2008 ng / L vs 70 ± 51 ng / L, P <0.01). The NT-proBNP levels in patients with cardiac function≥Ⅱlevel were significantly higher than those in patients with cardiac function Ⅰ level (3172.6 ± 2448.9 ng / L, 1175 ± 710.0 ng / L, P <0.01). NT-proBNP was positively correlated with K illip grade. CONCLUSION: The cardiac natriuretic peptide system is activated after AMI. The changes of cardiac natriuretic peptide system are related to the grading of cardiac function. However, those with no cardiac dysfunction and elevated atrial pressure are also significantly elevated.