| 重组人脑利钠肽对行补救PCI术的急性前壁心肌梗死患者预后的影响 |
| 投稿时间：2016-03-09 修订日期：2016-04-02 点此下载全文 |
| 引用本文：张克良,刘晓堃.重组人脑利钠肽对行补救PCI术的急性前壁心肌梗死患者预后的影响[J].医学研究杂志,2016,45(7):163-166 |
| DOI：
10.11969/j.issn.1673-548X.2016.07.044 |
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| 中文摘要:目的 探讨急性前壁ST段抬高型心肌梗死静脉溶栓同时给予重组人脑利钠肽（recombinant human brain natriuretic peptide，rhBNP），观察行补救PCI者术后心功能及主要心血管不良事件情况。方法 选择符合静脉溶栓治疗标准的急性前壁心肌梗死患者。尿激酶溶栓治疗时，分为rhBNP组、常规治疗组。对于ST段降幅不足50%者转院行补救性PCI，观察心肌酶酶峰、心功能，随访主要心脏不良事件（major adverse cardiac events，MACE）。结果 观察组酶峰水平均低于对照组（114.89±75.35 vs 178.93±92.60，P<0.05），心功能比较观察组优于对照组（P<0.05），MACE事件低于对照组（21.1% vs 53.8%，P<0.05）。结论 对于行补救性PCI的急性前壁心肌梗死患者早期使用rhBNP可减少心肌细胞坏死、改善左心室重构、改善心功能，减少MACE发生率，改善患者预后。 |
| 中文关键词:重组人脑利钠肽|急性心肌梗死|经皮冠状动脉介入治疗|心力衰竭|主要心血管不良事件 |
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| Effect of Recombinant Human Brain Natriuretic Peptide on Outcomes of Patients with Acute Anterior Myocardial Infarction Receiving Rescue Percutaneous Coronary Interventio |
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| Abstract:Objective To observe heart function and major adverse cardiac events in patients with acute ST elevated anterior infarction receiving percutaneous coronary intervention (PCI) after failure of intravenous fibrinolysis in combination of recombinant human brain natriuretic peptide (rhBNP). Methods Totally 451 patients with acute anterior infarction were recruited with the following inclusion criteria.Methods Patients receiving urokinase fibrinolysis were divided in to two groups, rhBNP group and routine group. Rescue PCI were performed after failure to fibrinolysis by transfer to PCI center. All patients receiving rescue PCI were further divided into two groups by receiving rhBNP (observation group) or not (control group). Creatine kinase (CK) and creatine kinase MB were measured. Transthoracic echocardiography was performed at 1 week, 4 weeks and 24 weeks after PCI. Major adverse cardiac events (MACE) such as recurrent angina pectoris, recurrent myocardial infarction, heart failure and cardiac shock had been observed until 24 weeks after PCI. All data were analyzed by SPSS 19.0 measurement data and quantitative data were expressed by mean±standard deviation and numbers (n) respectively and compared with t test and chi-square test respectively. Before and after self control data in multiple time points were analyzed by one-way ANOVA. P<0.05 was considered statistically significant. Results 108 patients were enrolled.CK and CK-MB in the observation group were significantly lower than that in the control group (P<0.05). Echocardiogram data such as LVEDd, LVESd, left ventricular fractional shortening and left ventricular ejection fraction at 1week, 4weks and 24weks time points in the observation group were better than that in the control group (P<0.05). Incidence of MACE in the observation group was lower than that in the control group 24 weeks after PCI (P<0.05). Conclusion Infusion of rhBNP earlier than rescue PCI in patients with acute anterior myocardial infarction could reduce damage to myocardial cells and improve both left remodeling of left ventricle and heart function, and could also lower incidence of MACE with improved outcomes. |
| keywords:rhBNP|AMI|PCI|Heart failure|MACE |
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