疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2015年
1期
13-15,19
,共4页
崔丽杰%李占全%苗志林%袁龙
崔麗傑%李佔全%苗誌林%袁龍
최려걸%리점전%묘지림%원룡
心肌梗死,急性%重组人脑利钠肽%心功能
心肌梗死,急性%重組人腦利鈉肽%心功能
심기경사,급성%중조인뇌리납태%심공능
Myocardial infarction,acute%Recombinant human brain natriuretic peptide%Heart function
目的：观察急性心肌梗死（AMI）患者直接经皮冠状动脉支架植入术（PCI）后静脉应用重组人脑利钠肽（ rhBNP）的长期疗效。方法选择98例AMI患者，随机分为rhBNP治疗组52例和生理盐水对照组46例。2组患者均予以药物治疗及直接PCI术。治疗组：直接PCI术中及术后静脉应用rhBNP，先按10.5μg／kg 负荷剂量静脉推注（＞3 min），后按0.01μg? kg-1? min-1静脉滴注（持续48 h）；对照组：PCI术中及术后应用生理盐水静脉滴注。2组在PCI术前检测血浆NT-proBNP。长期随访2.5～3年，观察主要心血管事件（ MACE）、心功能及血浆NT-proBNP变化。结果随访2.5～3年，平均2.7年。治疗组完成随访48例，对照组40例，治疗组血浆NT-proBNP显著低于对照组[分别为（971±89）pg／ml和（1644±106）pg／ml， t =0.275， P =0.04]；治疗组SV、LVEF高于对照组[分别为（46.2±4.2）ml和（50.1±6.7）ml， t =-1.870， P =0.03；（43.6±2.2）％和（48.6±2.4）％， t =-1.896， P =0.04]，LVEDD低于对照组（ t =0.246， P =0.04）；治疗组再发心力衰竭住院2例（4.2％），低于对照组7例（17.5％）（ P =0.04）。结论 AMI患者直接PCI术后早期应用rhBNP，长期随访观察可显著改善心功能。
目的：觀察急性心肌梗死（AMI）患者直接經皮冠狀動脈支架植入術（PCI）後靜脈應用重組人腦利鈉肽（ rhBNP）的長期療效。方法選擇98例AMI患者，隨機分為rhBNP治療組52例和生理鹽水對照組46例。2組患者均予以藥物治療及直接PCI術。治療組：直接PCI術中及術後靜脈應用rhBNP，先按10.5μg／kg 負荷劑量靜脈推註（＞3 min），後按0.01μg? kg-1? min-1靜脈滴註（持續48 h）；對照組：PCI術中及術後應用生理鹽水靜脈滴註。2組在PCI術前檢測血漿NT-proBNP。長期隨訪2.5～3年，觀察主要心血管事件（ MACE）、心功能及血漿NT-proBNP變化。結果隨訪2.5～3年，平均2.7年。治療組完成隨訪48例，對照組40例，治療組血漿NT-proBNP顯著低于對照組[分彆為（971±89）pg／ml和（1644±106）pg／ml， t =0.275， P =0.04]；治療組SV、LVEF高于對照組[分彆為（46.2±4.2）ml和（50.1±6.7）ml， t =-1.870， P =0.03；（43.6±2.2）％和（48.6±2.4）％， t =-1.896， P =0.04]，LVEDD低于對照組（ t =0.246， P =0.04）；治療組再髮心力衰竭住院2例（4.2％），低于對照組7例（17.5％）（ P =0.04）。結論 AMI患者直接PCI術後早期應用rhBNP，長期隨訪觀察可顯著改善心功能。
목적：관찰급성심기경사（AMI）환자직접경피관상동맥지가식입술（PCI）후정맥응용중조인뇌리납태（ rhBNP）적장기료효。방법선택98례AMI환자，수궤분위rhBNP치료조52례화생리염수대조조46례。2조환자균여이약물치료급직접PCI술。치료조：직접PCI술중급술후정맥응용rhBNP，선안10.5μg／kg 부하제량정맥추주（＞3 min），후안0.01μg? kg-1? min-1정맥적주（지속48 h）；대조조：PCI술중급술후응용생리염수정맥적주。2조재PCI술전검측혈장NT-proBNP。장기수방2.5～3년，관찰주요심혈관사건（ MACE）、심공능급혈장NT-proBNP변화。결과수방2.5～3년，평균2.7년。치료조완성수방48례，대조조40례，치료조혈장NT-proBNP현저저우대조조[분별위（971±89）pg／ml화（1644±106）pg／ml， t =0.275， P =0.04]；치료조SV、LVEF고우대조조[분별위（46.2±4.2）ml화（50.1±6.7）ml， t =-1.870， P =0.03；（43.6±2.2）％화（48.6±2.4）％， t =-1.896， P =0.04]，LVEDD저우대조조（ t =0.246， P =0.04）；치료조재발심력쇠갈주원2례（4.2％），저우대조조7례（17.5％）（ P =0.04）。결론 AMI환자직접PCI술후조기응용rhBNP，장기수방관찰가현저개선심공능。
Objective To observe the long-term effect of intravenous recombinant human brain natriuretic peptide (rhBNP) on acute myocardial infarction (AMI) patients after percutaneous coronary intervention (PCI).Methods Ninty-eight cases of patients with AMI were randomly divided into rhBNP treatment group with 52 cases and normal saline control group with 46 cases.2 groups of patients were treated with drug treatment and PCI operation .Treatment group:intraoperative and postoperative intravenous application of rhBNP was used , according to the 1.5μg/kg loading dose of intravenous injection (>3 min), followed by 0.01μg? kg-1? min-1(for 48 h);control group:during PCI operation and post operation applica-tion of intravenous saline infusion .Plasma NT-proBNP before PCI in the 2 groups were tested.Long-term follow up of 2.5-3 years, major adverse cardiovascular events ( MACE) , cardiac function and plasma NT-proBNP changes were observed .Re-sults Followed up for 2.5-3 years, average of 2.7 years.The treatment group with 48 cases were completed the follow-up, 40 cases in the control group were completed the follow-up, the plasma NT-proBNP in treatment group was significantly lower than that of the control group [(971 ±89) pg/ml and (1644 ±106) pg/ml, t =0.275, P =0.04];SV, LVEF in the treat-ment group were higher than the control group [(46.2 ±4.2) ml and (50.1 ±6.7) ml, t =-1.870, P =0.03;(43.6 ± 2.2)%and (48.6 ±2.4)%, t =-1.896, P =0.04],LVEDD was lower than control group ( t =0.246, P =0.04);2 cases in the treatment group recurred of heart failure (4.2%), which is lower than that of the control group of 7 cases (17.5%) ( P =0.04).Conclusion It demonstrated tha the long-term follow up revealed that early application of rhBNP after PCI in AMI patients could significantly improve heart function .
