心肌梗死患者急诊经皮冠状动脉介入术后脑钠肽的变化及临床特征

Variation of BNP level and clinical features of myocardial infacrction patients after percutaneous transluminal coronary intervention

摘要:

目的探讨ST 抬高型心肌梗死（STEMI）和非ST 抬高型心肌梗死（NSTEMI）急诊经皮冠状动脉介入术（PCI）后脑钠肽（BNP）的变化和临床特征。方法选取2015 年1 月-2015 年12 月急诊入住该院的首发急性心肌梗死患者126 例。根据患者入院心电图变化分为STEMI 组72 例和NSTEMI 组54 例，并根据冠脉造影结果，分为1 支冠脉病变组、2 支冠脉病变组和3 支冠脉病变组。选取正常患者20 例为对照组，测定患者入院后24 h及术后7 d的BNP 水平，比较各组间BNP水平的变化及其临床特征。结果入院后24 h 1 支病变组、2 支病变组和3 支病变组的STEMI 组的BNP 水平均高于NSTEMI 组，差异有统计学意义（P <0.05）。术后7 d 1 支病变组的STEMI 组和NSTEMI 组的BNP 水平比较差异无统计学意义（P >0.05），2 支病变组、3 支病变组的STEMI 组的BNP 水平低于NSTEMI 组，差异有统计学意义（P <0.05）。结论急性心肌梗死患者急诊PCI 后BNP 水平的变化及相关临床特征，有助于更为准确的判断病情、进行危险分层和评估长期的预后等。

Abstract:

Objective To investigate the variation of brain natriuretic peptide (BNP) level and clinical features of ST -segment elevation myocardial infarction (STEMI) patient and Non -ST -segment elevation myocardial infarction (NSTEMI) patients after percutaneous coronary intervention (PCI). Methods A total of 126 patients with first attack of acute myocardial infarction in our emergency department were collected from January 2015 to December 2015. Patients were divided into STEMI group (72 cases) and NSTEMI group (54 cases) according to results of electrocardiogram. The patients were further divided into single vessel lesion group, two-vessel lesion group and three-vessel lesion group according to results of coronary angiography. Plasma BNP was measured 24 hours after admission and 7 days after PCI, and BNP level and clinical features were compared between the groups. Results At 24 hours after admission, BNP levels of single vessel lesion group, two-vessel lesion group and three-vessel lesion group in the STEMI group were respectively significantly higher than those in the NSTEMI group (P < 0.05). At 7 days after PCI, there was no significant difference in BNP levels of single vessel lesion group between the STEMI group and the NSTEMI group (P >0.05); the BNP levels of two-vessel lesion group and three-vessel lesion group in the STEMI group were respectively lower than those in the NSTEMI group (P < 0.05). Conclusions Assessment of BNP level andclinical features to myocardial infarction patients after PCI is helpful for more accurate judgment of health condition, risk stratification and assessment of long-term prognosis.