CAJ | 학술논문

目的：研究重组人脑利钠肽（rhBNP）对急性心肌梗死早期高危患者早期心功能及左室重塑的影响。方法选取2013年1月至2014年09月山西医科大学附属汾阳医院心内科收治的首次急性心肌梗死（AMI）患者52例，男性28例，女性24例，年龄41~75岁，平均年龄（60.8±9.8）岁。所有患者随机分为rhBNP组（n=23）和对照组（n=29）。对照组仅给予常规治疗，rhBNP组在常规治疗的基础上静脉泵入rhBNP3~5 d。测定两组患者入院即刻、入院1周后N末端脑钠肽前体（NT-proBNP）、左室射血分数（LVEF）、左室舒张末期内径（LVEDd），记录1周后心功能Killip分级、心源性死亡。结果两组入院1周后临床心功能Killip分级情况以及心源性死亡比例比较，差异无统计学意义（P均＞0.05）。与治疗前比较，治疗后对照组NT-proBNP水平升高，rhBNP组降低，差异有显著统计学意义（P均＜0.01）。两组治疗后较治疗前LVEF升高，LVEDd增加，差异有统计学意义（P均＜0.05）。与对照组治疗后比较，rhBNP组NT-proBNP水平降低[（2204.94±830.90）pg/mlvs.（1498.29±707.33）pg/ml]，LVEDd减少[（53.60±5.25）mmvs.（49.87±3.36）mm]，差异有明显统计学意义（P均＜0.01）。结论 AMI早期高危患者及早应用rhBNP治疗可以有效改善心功能、抑制早期左室重塑。
목적：연구중조인뇌리납태（rhBNP）대급성심기경사조기고위환자조기심공능급좌실중소적영향。방법선취2013년1월지2014년09월산서의과대학부속분양의원심내과수치적수차급성심기경사（AMI）환자52례，남성28례，녀성24례，년령41~75세，평균년령（60.8±9.8）세。소유환자수궤분위rhBNP조（n=23）화대조조（n=29）。대조조부급여상규치료，rhBNP조재상규치료적기출상정맥빙입rhBNP3~5 d。측정량조환자입원즉각、입원1주후N말단뇌납태전체（NT-proBNP）、좌실사혈분수（LVEF）、좌실서장말기내경（LVEDd），기록1주후심공능Killip분급、심원성사망。결과량조입원1주후림상심공능Killip분급정황이급심원성사망비례비교，차이무통계학의의（P균＞0.05）。여치료전비교，치료후대조조NT-proBNP수평승고，rhBNP조강저，차이유현저통계학의의（P균＜0.01）。량조치료후교치료전LVEF승고，LVEDd증가，차이유통계학의의（P균＜0.05）。여대조조치료후비교，rhBNP조NT-proBNP수평강저[（2204.94±830.90）pg/mlvs.（1498.29±707.33）pg/ml]，LVEDd감소[（53.60±5.25）mmvs.（49.87±3.36）mm]，차이유명현통계학의의（P균＜0.01）。결론 AMI조기고위환자급조응용rhBNP치료가이유효개선심공능、억제조기좌실중소。
Objective To study the influences of recombinant human brain natriuretic peptide (rhBNP) on heart function and left ventricular remodeling in high risk patients with early acute myocardial infarction (AMI). Methods The patients [n=52, male 28, female 24, aged from 41 to 75 and average age=(60.8±9.8)] with first time AMI were chosen from Jan. 2013 to Sept. 2014. All patients were randomly divided into rhBNP group (n=23) and control group (n=29), and control group was given only routine therapy and rhBNP group was given rhBNP for 3-5 d besides of routine therapy. The changes of NT-proBNP, LVEF and LVEDd were detected immediately and 1 w after hospitalization, and Killip scores and cardiac death were recorded after 1 w.Results The difference in Killip scores and percentage of cardiac death had no statistical significance between 2 groups 1 w after hospitalization (all P>0.05). The level of NT-proBNP increased in control group and decreased in rhBNP group after treatment (all P<0.01), and LVEF and LVEDd all increased in 2 groups after treatment (allP<0.05). After treatment, NT-proBNP level decreased [(2204.94±830.90) pg/mlvs. (1498.29±707.33) pg/ml] and LVEDd decreased [(53.60±5.25) mm vs. (49.87±3.36) mm] in rhBNP group compared with control group (P<0.01).Conclusion The administration of rhBNP as early as possible can effectively improve heart function and inhibit early left ventricular remodeling in high risk patients with early AMI.