急性心肌梗死患者脑钠肽浓度的变化及意义

目的　探讨冠状动脉粥样硬化性心脏病急性心肌梗死 (AMI)患者血浆脑钠肽 (BNP)浓度的变化及其临床意义。方法　采用酶联免疫吸附试验 (ELISA)方法测定 2 0例冠状动脉造影正常、心功能正常者及 6 0例AMI患者静脉血BNP浓度。结果　AMI心功能Killip3级组、Killip2级组及Killip1级组血浆BNP浓度分别高于Killip2级组、Killip1级组和对照组 (P <0 0 5,P <0 0 5,P <0 0 1) ;冠脉 3支病变组BNP浓度高于 1支病变组(P <0 0 0 5) ,广泛前壁组 (E组 )、前壁和 /或前间壁组 (A组 )BNP浓度均高于下壁和 /或后壁组 (I组 ) (按梗死部位分组 ,P <0 0 5) ;E组和A组间BNP浓度无显著性差异 (P >0 0 5)。结论　AMI时组血浆BNP浓度明显升高 ,心衰越重其浓度越高 ,3支病变或前壁梗死患者变化可能更为明显

Significance of Brain Natriuretic Peptide in Patients with Acute Myocardial Infarction

ObjectiveTo explore the variation and significance of brain natriure tic peptide (BNP) level in patients with acute myocardial infarction (AMI). MethodsThe study included 60 AMI patients and 20 healthy p ersons (control group) wi th normal coronary artery angiogram (CAG) and heart function. CAG was performed in all patients (not including two shock patients). According to Killip class, A MI patients were divided into Killip 4 group (K4), Killip 3 group (K3), Killip 2 group (K2) and Killip 1 group (K1). They were again divided into 3 vessels dise ase group (V3), 2 vessels disease group (V2) and 1 vessel disease group(V1) by CAG. At the same time, according to ECG they were divided into I group (inferior and /or posterior wall infarction (I), A group (anterior and /or anterior septa l wall infarction (A) and E group (extensive anterior wall infarction (E). BNP i n plasma was measured by enzymelinked immunosorbent assay (ELISA). ResultsThe plasma BNP lev el in K3, K2, K1 and V3 was higher than that in K2, K1, control group and V1 ( P<0 05,P<0 05, P< 0 01 and P <0 005, respectively). But pla sma BNP le vel in K4 was much lower than that in other AMI groups and even lower than that in control group. The BNP level in E or A group was higher than that in I group ( P <0 05). There was no significant difference between E and A ( P >0 0 5). ConclusionsPlasma BNP level increased significantly after AM I . It seems more significant in patients with 3 coronary vessels disease or anter ior wall infarction. The more severe was heart failure, the higher level of BNP.