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目的:探讨血浆脑钠素(BNP)水平升高与行急诊冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死心肌灌注及临床结果的关系。方法:研究入选急诊PCI的急性ST段抬高型心肌梗死患者40例,于PCI后采集血液检测血浆BNP水平,根据BNP中位数将患者分为2组,高BNP组(H组:BNP≥152ng/L)和低BNP组(L组:BNP<152ng/L)。比较2组患者特征、心电图ST段回落、左室收缩功能和住院期间主要并发症。结果:H组较L组糖尿病患者多(65%∶45%,P<0.05)、ST段回落减少(55%∶90%,P<0.01)、左室收缩功能降低[左室射血分数(52±13)%∶(61±11)%,P<0.01]、左室舒张末期容积减少[(146±32)ml∶(121±28)ml,P<0.01]、住院期间急性左心衰竭发生增多(25%∶5%,P<0.01)。结论:急性ST段抬高型心肌梗死急诊PCI患者,血浆BNP的升高与心肌灌注受损相关,与住院期间急性左心衰竭发生有关。
Objective: To investigate the relationship between elevated plasma BNP and myocardial perfusion in patients with acute ST-segment elevation myocardial infarction undergoing emergency coronary intervention (PCI) and its clinical outcome. Methods: Forty patients with acute ST-segment elevation myocardial infarction who were enrolled in emergency PCI were enrolled. Blood samples were taken after PCI to detect plasma BNP levels. According to the median of BNP, patients were divided into two groups: high BNP group (group BNP≥ 152ng / L) and low BNP group (L group: BNP <152ng / L). The characteristics of two groups were compared, ST-segment depression of ECG, left ventricular systolic function and major complications during hospitalization. Results: Compared with L group, patients in group H had more drop (65% vs 45%, P <0.05), ST-segment regression decreased (55%: 90%, P <0.01), decreased left ventricular systolic function 52 ± 13)%, (61 ± 11)%, P <0.01]. The decrease of left ventricular end diastolic volume was (146 ± 32) ml (121 ± 28) ml, P <0.01] Increased (25%: 5%, P <0.01). Conclusions: Elevated plasma BNP level is associated with impaired myocardial perfusion in acute ST-segment elevation myocardial infarction (PCI) patients and is associated with acute left ventricular failure during hospitalization.