冠脉介入治疗对冠心病急性心肌梗死患者血浆B型钠利尿肽水平及心室重塑的影响

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目的分析冠脉介入治疗对冠心病急性心肌梗死患者血浆B型钠利尿肽水平及心室重塑的影响及运用价值。方法抽取2015年1月—2016年6月本院收治的82例冠心病急性心肌梗死患者,根据是否接受介入治疗分为介入组和非介入组,各41例。采用电化学发光法测定两组患者肌酸激酶(CK)、肌酸激酶同工酶(CKMB);采用酶联免疫吸附测定法检测B型钠利尿肽(BNP);通过彩色超声多普勒检查左室射血分数(LVEF)、左心室舒张末期容积(EDV)、左心室收缩末期容积(ESV)。对比观察两组患者治疗7d后CK、CK-MB峰值检测结果、心脏超声检测结果及不同时间段BNP水平变化情况。结果介入组治疗7d后CK、CK-MB峰值高于非介入组,但组间比较差异无统计学意义(P>0.05);介入组LVEF、EDV、ESV各指标水平均明显优于对照组,差异有统计学意义(P<0.05);两组患者入院时及2d内,血浆BNP水平比较差异无统计学意义(P>0.05),入院3d后,介入组BNP水平明显低于非介入组,差异有统计学意义(P<0.05)。结论对冠心病急性心肌梗死行冠脉介入治疗,可有效改善心肌梗死后血浆BNP水平、最大程度减轻心室重构,对疾病良好转归具有重要促进作用,值得推广运用。 Objective To analyze the effect of percutaneous coronary intervention on plasma B - type natriuretic peptide and ventricular remodeling in patients with acute myocardial infarction with coronary heart disease and its clinical value. Methods A total of 82 patients with acute myocardial infarction (CHD) admitted to our hospital from January 2015 to June 2016 were divided into intervention group and non-intervention group according to whether they received interventional therapy or not, 41 patients in each group. The levels of creatine kinase (CK) and creatine kinase MB (CKMB) were measured by electrochemiluminescence. B-type natriuretic peptide (BNP) was detected by enzyme-linked immunosorbent assay Left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (EDV) and left ventricular end-systolic volume (ESV). The CK, CK-MB peak value, the results of echocardiography and the changes of BNP levels at different time points were compared between the two groups after 7 days of treatment. Results The peak values ​​of CK and CK-MB in intervention group were higher than those in non-intervention group after 7 days of treatment, but there was no significant difference between two groups (P> 0.05). The levels of LVEF, EDV and ESV in intervention group were significantly better than those in control group (P <0.05). There was no significant difference in plasma BNP levels between the two groups at admission and within 2 days (P> 0.05). After 3 days of admission, BNP level in intervention group was significantly lower than that in non-intervention group The difference was statistically significant (P <0.05). Conclusions Percutaneous coronary intervention in patients with acute myocardial infarction with coronary heart disease can effectively improve plasma BNP level after myocardial infarction and minimize ventricular remodeling, which plays an important role in promoting the prognosis of disease. It is worth promoting.
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