摘要
目的:探讨冠脉介入治疗(PCI)对急性左室下壁和前壁心肌梗死患者血浆脑利钠肽(BNP)、醛固酮(Ald)水平及近期预后的影响。方法:分析治疗前212例急性下壁(140例)、前壁(72例)心肌梗死患者血浆BNP、Ald水平及与冠脉病变的关系;比较两组患者直接、延迟PCI治疗后血浆BNP、Ald水平的变化及对近期预后的影响。结果:PCI治疗前,与急性下壁梗死组比较,急性前壁梗死组患者血浆BNP[(642.06±235.08)ng/L比(856.54±223.50)ng/L]、Ald[(50.26±5.23)ng/dl比(88.34±8.52)ng/dl]水平、冠脉狭窄程度[(82.28±7.65)%比(90.64±7.54)%]及3支病变发生率(22.52%比39.66%)均明显升高(P均<0.05);直接和延迟PCI治疗后,血浆BNP、Ald水平明显下降(P均<0.01),且直接PCI组较延迟PCI组血浆BNP[急性下壁梗死组:(216.93±119.86)ng/L比(453.75±107.54)ng/L,急性前壁梗死组:(245.754±121.52)ng/L比(483.04±164.65)ng/L]、Ald[急性下壁梗死组:(40.09±6.55)ng/dl比(45.34±8.15)ng/dl,急性前壁梗死组:(43.65±3.50)ng/dl比(50.43±9.21)ng/dl]水平下降更显著(P均<0.01);未行PCI治疗的患者近期死亡发生率明显高于行直接PCI及延迟PCI治疗的患者(11.63%比2.78%比3.28%,P均<0.05)。结论:急性前壁心肌梗死患者血浆BNP、Ald水平高,冠脉病变严重;直接PCI较延迟PCI治疗血浆BNP、Ald浓度下降幅度更大,未行PCI治疗的患者死亡率较高。
Objective：To explore the influence of percutaneous coronary intervention （PCI） on plasma levels of brain natri‐uretic peptide （BNP） and aldosterone （Ald） and short‐term prognosis in patients with acute left ventricular inferior and an‐terior wall myocardial infarction .Methods：A total of 212 patients were divided into acute inferior myocardial infarction （AIMI） group （n=140） and acute anterior myocardial infarction （AAMI） group （n=72） .Relationship among plasma lev‐els of BNP and Ald and coronary artery disease were analyzed in two groups .Changes of plasma levels of BNP and Ald after direct/delayed PCI and influence of PCI on short‐term prognosis were compared between two groups .Results：Compared with AIMI group before PCI ,there were significant rise in plasma levels of BNP [ （642.06 ± 235.08） ng/L vs .（856.54 ± 223.50） ng/L] and Ald [（50.26 ± 5.23） ng/dl vs .（88.34 ± 8.52） ng/dl] ,extent of coronary stenosis [（82.28 ± 7.65）%vs .（90.64 ± 7.54）% ] and incidence rate of triple‐vessel coronary disease （22.52% vs .39.66% ） in AAMI group , P〈0.05 all;plasma levels of BNP and Ald significantly reduced in both groups after direct /delayed PCI （P〈0.01 both） ,com‐pared with delayed PCI group ,there were significant reductions in plasma levels of BNP [AIMI group：（453.75 ± 107.54） ng/L vs .（216.93 ± 119.86） ng/L ,AAMI group：（483.04 ± 164.65） ng/L vs .（245.754 ± 121.52） ng/L] and Ald [AIMI group：（45.34 ± 8.15） ng/dl vs .（40.09 ± 6.55） ng/dl ,AAMI group：（50.43 ± 9.21） ng/dl vs .（43.65 ± 3.50） ng/dl] in direct PCI group , P〈0.01 all;short‐term mortality rate of patients not undergoing PCI was significantly higher than those of patients undergoing direct PCI and delayed PCI （11.63% vs .2.78% vs .3.28% , P〈0.05 both ） .Conclusion：Plasma levels of BNP and Ald are higher and coronary disease is more severe in AAMI patients ;compared with delayed PCI ,plas‐ma concentrations of BNP
出处
《心血管康复医学杂志》
CAS
2015年第2期182-185,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心肌梗死
血管成形术
气囊
冠状动脉
利钠肽
脑
醛固酮
Myocardial infarction
Angioplasty,balloon,coronary
Natriuretic peptide,brain
Aldosterone
