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目的:本研究旨在通过分析急性 ST 段抬高心肌梗死患者基础及经皮冠状动脉介入治疗(PCI)后 B 型利钠肽(BNP)水平,探讨 PCI 治疗对 BNP 水平的影响及 BNP 与近期预后的关系。方法:入选急性 ST 段抬高心肌梗死患者103例,依据入院后治疗方式分为6小时内 PCI 组40例,6～12小时 PCI 组33例,药物治疗组30例。所有患者于入院即刻、发病48小时及7天时从外周静脉中留取血样测定 BNP,分别比较不同时间不同治疗方式之间 BNP 的差别,以及 BNP 与1个月时心功能的关系。所有患者均无心力衰竭、陈旧性心肌梗死及肺部、肾脏疾病史。结果:①3组患者入院即刻基础 BNP 水平无统计学意义(P>0.05)。发病48小时、7天时6小时内 PCI 组 BNP 水平较6～12小时 PCI 组均明显下降,差异均有统计学意义(P<0.05～0.01),6小时内 PCI 组较药物治疗组亦明显下降,差异均有统计学意义(P<0.05～0.01);发病48小时6～12小时 PCI 组 BNP 水平与药物治疗组相比较差异无统计学意义(P>0.05)。发病7天时6～12小时 PCI 组 BNP 水平与药物治疗组比显著下降,差异有统计学意义(P<0.05)。②发病7天时的 BNP 水平与1个月时心功能左心室射血分数有明显相关性(r=-0.722,P<0.001),与 Tei 指数呈正相关(r=0.582,P<0.001)。③随访时发生心力衰竭、心绞痛及心血管事件的患者回顾发病7天时 BNP 水平明显高于未发生者(P<0.05～0.001)。结论:在急性 ST 段抬高心肌梗死患者中,发病7天时 BNP 水平与近期心功能显著相关,对近期心血管事件的发生有一定预测作用,早期 PCI 可以显著降低发病7天时 BNP 水平及降低心血管事件的发生率。
Aims: This study aimed to investigate the effects of PCI on the level of BNP by analyzing the basis of patients with acute ST-elevation myocardial infarction and the level of B-type natriuretic peptide (BNP) after percutaneous coronary intervention (PCI) Prognosis of the relationship. Methods: A total of 103 patients with acute ST-segment elevation myocardial infarction were enrolled in this study. According to the post-admission treatment, they were divided into 6 groups: 40 cases in PCI group, 33 cases in 6-12 hours PCI group and 30 cases in drug therapy group. Blood samples were collected from the peripheral vein immediately after admission, at 48 hours and 7 days after onset, respectively. The differences of BNP between different treatments and the relationship between BNP and cardiac function at 1 month were compared. All patients had no heart failure, old myocardial infarction and lung, kidney disease history. Results: There was no significant difference in basal BNP level between the three groups at admission (P> 0.05). The incidence of BNP in PCI group was significantly lower than that in PCI group (6-12 hours) after 48 hours of onset and 6 hours of PCI at 7 days (P <0.05-0.01). PCI group also significantly decreased in 6 hours (P <0.05 ~ 0.01). There was no significant difference in the level of BNP in PCI group between 6 and 12 hours after PCI at 48 hours (P> 0.05). The BNP level in PCI group decreased significantly from 6 to 12 hours after onset of the disease at 7 days, the difference was statistically significant (P <0.05). ② The BNP level at 7 days after onset was significantly correlated with left ventricular ejection fraction at 1 month (r = -0.722, P <0.001), and positively correlated with Tei index (r = 0.582, P <0.001). Patients with heart failure, angina pectoris and cardiovascular events at follow-up had a significantly higher level of BNP at 7 days after onset than those without (P <0.05-0.001). CONCLUSIONS: In patients with acute ST-segment elevation myocardial infarction, BNP level correlates significantly with recent cardiac function at 7 days of onset and may predict the occurrence of recent cardiovascular events. Early PCI can significantly reduce BNP levels and decrease heart rate at 7 days The incidence of vascular events.