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目的研究急性ST段抬高心肌梗死(AMI)患者早期再灌注治疗前后脑钠素(BNP)和心肌肌钙蛋白T(cTNT)的变化及临床意义。方法将57例患者分为下壁和前壁再灌注和非再灌注治疗的4小组,于入院即刻和入院后第4d分别测定血浆BNP和cTNT值并与对照组比较。结果入院时对照组与下壁和前壁组BNP值比较,差异有统计学意义(χ2=19.997,P=0.000);下壁组与前壁组cTNT值比较差异无统计学意义(P>0.05);再灌注治疗第4d,下壁组2小组BNP值比较差异有统计学意义(P<0.01),cTNT值比较差异无统计学意义(P>0.05);前壁组2小组BNP和cTNT值比较差异均无统计学意义(P均>0.05);患者心梗后BNP与cTNT浓度均升高;入院时BNP与cTNT无相关性(R=O.126,P=0.349),再灌注组第4d测BNP与cTNT呈线性正相关(R=0.425,P=0.024),非再灌注组第4d测BNP与cTNT无相关性(R=0.233,P=0.223)。结论急性心肌梗塞BNP浓度明显升高;早期再灌注治疗后血浆BNP浓度明显降低。
Objective To investigate the changes of brain natriuretic peptide (BNP) and cardiac troponin T (cTNT) in patients with acute ST-segment elevation myocardial infarction (AMI) before and after reperfusion and its clinical significance. Methods 57 patients were divided into 4 subgroups of reperfusion and non-reperfusion on inferior wall and anterior wall. Plasma BNP and cTNT were measured immediately after admission and 4 days after admission, and compared with control group. Results There was significant difference in BNP between control group and inferior wall and anterior wall group at admission (χ2 = 19.997, P = 0.000); there was no significant difference in cTNT between inferior wall group and anterior wall group (P> 0.05 (P <0.01). There was no significant difference in cTNT between the two groups (P> 0.05). The BNP and cTNT values in the two groups of anterior wall group (P> 0.05). The concentrations of BNP and cTNT in patients with myocardial infarction were significantly higher than those in control group (P = 0.349, P = 0.349) There was a linear positive correlation between BNP and cTNT at 4 days (R = 0.425, P = 0.024). There was no correlation between BNP and cTNT at 4 days after non-reperfusion (R = 0.233, P = 0.223). Conclusions The concentration of BNP in acute myocardial infarction is obviously increased. The concentration of plasma BNP is obviously decreased after early reperfusion.