急性非ST段抬高心肌梗死患者不同治療方式BNP變化及左心室重構分析

摘要： 目的探討急性非ST段抬高心肌梗死患者不同治療方式B型尿鈉肽(B-type natriuretic peptide,BNP)的變化及左心室重構情況。方法選擇2010年2月-2011年8月初發(fā)急性心肌梗死患者104例,根據不同的治療方式分為經皮冠狀動脈介入治療(percutaneous coronary mtervention,PCI)治療組54例和藥物非手術治療組50例,觀察入院時及發(fā)病后4周BNP、左心室舒張末期容積(left ventriculmend-diastolicvolume,LVEDV)和左心室收縮末期容積(left ventricular end systolic volume,LVESV)變化。結果 PCI治療組與藥物非手術治療組入院時BNP值相比較差異無統計學意義(P>0.05),發(fā)病4周后PCI治療組BNP值明顯低于藥物非手術治療組(P<0.05)。LVESV及LVEDV在入院時及發(fā)病4周后2組之間比較差異均無統計學意義。結論在排除心功能的影響下,經過不同的治療后,PCI治療組平均BNP水平明顯低于藥物非手術治療組,4周時隨訪左心室重構指標在2組之間差異無統計學意義。
Objective To investigate the changes of the B - type natriuretic peptide(BNP) and left ventricle reconstitution in acute non - ST elevated myocardial infarction patients with different therapy.Methods A total of 104 cases of primary acute non - ST elevated myocardial infarction patients from February 2010 to August 2011 were selected.According to different treatments,the subjects were randomly divided into two groups:Percutaneous coronary artery intervention(PCI) treatment group (n=54) and conservative drug treatment group(n = 50 ).The changes of BNP,left ventricular end systolic volume(LVESV) and left ventricular end -diastolic volume(LVEDV) on admission and 4 weeks after infarction onset were observed.Results On admission,the BNP level had no difference between PCI treatment group and conservative medical treatment group(P > 0.05 ),but there were significant difference 4 weeks after infarction onset between the two groups(P <0.05).LVESV and LVEDV had no significant difference between two groups at admission and 4 weeks after infarction onset.Conclusion Excluding the effect of the heart function,after different therapy,the average BNP level was significantly lower in PCI treatment group than that of conservative medicine therapy group.After a followed - up of four weeks,the index of left ventricle reconstitution had no statistical difference between the two groups.