急性心肌梗死患者早期血浆脑钠肽水平与左室重构及预后关系的评估

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间呈正相关。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。

Assessment of Relationship of Early Plasma Brain Natriuretic Peptide and Left Ventricular Remodeling and Prognosis in Patients with Acute Myocardial Infarction

Objective： To investigate the relationship between early brain natriuretic peptide（BNP） levels and left ventricular remodeling and prognosis in acute myocardial infarction（AMI）.Methods： Determine plasma BNP levels in patients with early AMI by radioimmunoassay;Measure left ventricular end systolic volume（ESV）,left ventricular end diastolic volume（EDV）,ejection fraction（EF） by echocardiography,and left ventricle through the calculated mass（LVM）.Group according to left ventricular volume index： left ventricular volume increasing rate 20% was left ventricular remodeling group,or else non-reconstructed group,plasma BNP levels of the two groups were compared.Results： The recovery of left ventricular end-diastolic reconstruction group and end-systolic volume index were higher than those of non-reconstructed group（P 0.01）,also higher than the acute phase left ventricular volume（P 0.01）.Recon-struction of the early group was significantly higher than plasma BNP concentration reconstruction group（P 0.01）,recovery is also high-er than non-reconstructed group（P 0.01）.BNP concen-tration and the reconstruction of the early recovery group left ventricular volume and volume variation of the question,a positive correla-tion.Conclusion： AMI increased with early BNP is closely related to acute left ventricular remodeling and plasma BNP levels can be used as thrombolytic recanalization therapy and prognosis based on observed indi-cators.