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目的:探讨急性心肌梗死(AMI)患者血浆脑钠尿肽(BNP)与左心室射血分数(LVEF)、左心室舒张末容积(LVEDV)、Killip分级及心肌梗死部位的关系,评价BNP对AMI患者心功能和危险分层的预测价值。方法:检测120例AMI患者和120例对照组血浆BNP水平,同时行心脏彩色多普勒检测LVEF、LVEDV,比较AMI组与对照组以及不同LVEF、Killip分级和不同梗死部位亚组间的血浆BNP水平差异。结果:与对照组相比,AMI组BNP和LVEDV显著升高,LVEF显著降低(均P<0.01)。与LVEF>50%组比较,LVEF<40%组BNP、LVEDV显著升高(P<0.05);与Killip I、II级比较,Killip III、IV级组BNP显著升高(P<0.05),Killip IV级组LVEDV显著增大(P<0.05)。与下壁心肌梗死患者相比,下后壁、前壁梗死患者BNP显著升高(P<0.05)。BNP与Killip分级成正相关(r=0.97,P<0.05),与LVEF成负相关(r=-0.33,P<0.05)。结论:AMI患者血浆BNP显著增高,尤以LVEF<40%、Killip IV级、前壁心肌梗死者为甚。
Objective: To investigate the relationship between plasma BNP and left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), Killip grade and myocardial infarction in patients with acute myocardial infarction (AMI) Predictive value of cardiac function and risk stratification in patients. Methods: Plasma BNP levels were measured in 120 patients with AMI and 120 controls. Cardiac color Doppler was used to detect LVEF and LVEDV. Plasma BNP levels were compared between AMI group and control group, and between subgroups of different LVEF, Killip classification and different infarction sites Horizontal difference. Results: Compared with the control group, BNP and LVEDV were significantly increased in AMI group and LVEF was significantly decreased (all P <0.01). BNP and LVEDV in LVEF> 40% group were significantly higher than those in LVEF> 50% group (P <0.05). Compared with Killip I and II group, BNP in Killip III and IV group was significantly increased (P <0.05) IVED group LVEDV increased significantly (P <0.05). Compared with patients with inferior myocardial infarction, BNP was significantly increased in patients with inferior posterior wall and anterior wall infarction (P <0.05). BNP was positively correlated with Killip grade (r = 0.97, P <0.05), and negatively correlated with LVEF (r = -0.33, P <0.05). CONCLUSIONS: Plasma BNP was significantly higher in AMI patients, especially LVEF <40%, Killip class IV, and anterior myocardial infarction.