摘要
目的观察急性心肌梗死患者急诊PCI术后早期应用脑钠肽对神经内分泌激素、血管内皮功能及心功能的影响。方法选择2017年1月—2018年6月石家庄市第一医院心内科收治急性心肌梗死急诊PCI术后患者60例作为研究对象,随机数字表法分为观察组及对照组各30例。2组患者均给予心肌梗死基础药物治疗,观察组另予脑钠肽静脉泵注72 h,比较2组治疗72 h后E、NE、AngⅡ水平,治疗后2周及3个月的FMD、NO、ET-1、NT-proBNP水平及心功能变化。结果治疗72 h后2组血浆E、NE、AngⅡ指标均较治疗前下降,且观察组下降较对照组更显著(t/P=16.345/<0.001、3.297/0.002、9.617/<0.001);与治疗前比较,治疗后2组患者FMD、NO均升高,ET-1水平下降,但对照组变化无统计学意义(P>0.05),而观察组改善显著(治疗后2周:t/P=8.666/<0.001,4.642/<0.001,13.457/<0.001;治疗后3个月:t/P=6.210/<0.001,4.902/<0.001,2.149/0.036);治疗后2周、3个月2组患者NT-proBNP、LVEDD、LVEF、FS指标均有所改善,3个月较2周进一步改善,且观察组较对照组改善更明显(治疗后2周:t/P=5.620/<0.001,26.609/<0.001,4.751/<0.001,23.257/<0.001;治疗后3个月:t/P=7.044/<0.001,2.790/0.007,4.016/<0.001,2.496/0.015)。结论急性心肌梗死患者急诊PCI术后早期应用脑钠肽可以调节神经内分泌激素,改善血管内皮功能,并对心肌重构具有重要作用,进而改善患者心功能,改善预后。
Objective To observe the effect of brain natriuretic peptide on neuroendocrine hormone,vascular endothelial function and cardiac function in patients with acute myocardial infarction after PCI.Methods From January 2017 to June 2018,60 patients with acute myocardial infarction after PCI were selected as the study object.Randomly divided into observation group and control group with 30 cases each.The patients in both groups were treated with basic drugs for myocardial infarction.In the observation group,brain natriuretic peptide was injected intravenously for 72 hours.The levels of E,NE,angⅡ,FMD,NO,ET-1,NT-proBNP and cardiac function of the two groups were compared at 72 hours,2 weeks and 3 months after treatment.Results After 72 hours of treatment,the plasma E,NE,angⅡindexes of the two groups were lower than before treatment,and the decrease of the observation group was more significant than that of the control group(t/P=16.345/<0.001,3.297/0.002,9.617/<0.001).Compared with before treatment,FMD,NO and ET-1 levels of the two groups were increased,but there was no significant difference in the control group(P>0.05).But the observation group improved significantly(2 weeks after treatment:t/P=8.666/<0.001,4.642/<0.001,13.457/<0.001;3 months after treatment:t/P=6.210/<0.001,4.902/<0.001,2.149/0.036).NT-proBNP,LVED,LVEF and FS were improved in two weeks and three months after treatment.Three months later,it was further improved than two weeks,and the improvement of the observation group was more obvious than that of the control group(2 weeks after treatment:t/P=5.620/<0.001,26.609/<0.001,4.751/<0.001,23.257/<0.001;3 months after treatment:t/P=7.044/<0.001,2.790/0.007,4.016/<0.001,2.496/0.015).Conclusions Early application of brain natriuretic peptide after PCI in patients with acute myocardial infarction can regulate neuroendocrine hormones,improve vascular endothelial function,and play an important role in myocardial remodeling,thereby improving cardiac function and prognosis.
作者
张莹洁
任岩春
赵永峰
董静杰
吴志红
胡喜田
Zhang Yingjie;Ren Yanchun;Zhao Yongfeng;Dong Jingjie;Wu Zhihong;Hu Xitian(Department of Cardiology, First Hospital of Shijiazhuang, Shijiazhuang 050011,China)
出处
《疑难病杂志》
CAS
2020年第5期447-451,共5页
Chinese Journal of Difficult and Complicated Cases
基金
石家庄市科学技术研究与发展指导计划项目(161462493)。
关键词
脑钠肽
心肌梗死
急性
神经内分泌激素
血管内皮功能
心功能
心室重构
Brain natriuretic peptide
Acute myocardial infarction
Neuroendocrine hormone
Vascular endothelial function
Cardiac Function
Left ventricular remodeling
