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[目的]观察不同梗死部位的急性心肌梗死患者血浆N-末端脑钠肽前体(NT-proBNP)水平及早期使用比索洛尔干预的影响。[方法]98例急性心肌梗死患者根据心电图改变特点分为下、后壁梗死组(A组,n=22),前侧壁梗死组(B组,n=24),前间壁梗死组(C组,n=20),广泛前壁梗死组(D组,n=24);以年龄相当的23例非冠心病患者作为对照组,入院后测定各组血浆NT-proBNP,将梗死患者随机分为常规治疗组(n=48)和加用比索洛尔组(n=50),分别于治疗1周和1月时再次测定其血浆NT-proBNP。[结果]急性心肌梗死患者血浆NT-proBNP水平D组﹥B组﹥C组﹥A组﹥对照组(分别P﹤0.05),急性心肌梗死患者治疗1周后及治疗1月后血浆NT-proBNP与治疗前比较均显著下降(分别P﹤0.05),两组间比较均有显著性差别,比索洛尔治疗组NT-proBNP下降明显。[结论]急性心肌梗死患者血浆NT-proBNP水平均明显升高并与梗死部位有关,广泛前壁心肌梗死患者血浆NT-proBNP明显升高,下后壁心肌梗死患者血浆NT-proBNP升高最低;早期使用比索洛尔有效可降低急性心肌梗死患者血浆NT-proBNP水平。
[Objective] To observe the influence of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and early use of bisoprolol intervention in patients with acute myocardial infarction at different infarct sites. [Methods] 98 patients with acute myocardial infarction were divided into the posterior wall infarction group (A group, n = 22), anterior wall infarction group (B group, n = 24), anterior wall infarction group (N = 20), and extensive anterior wall infarction (group D, n = 24). Twenty-three non-CHD patients with the same age as the control group. Plasma NT-proBNP was measured in all groups after admission. Plasma NT-proBNP was measured again at 1 week and 1 month of treatment in the conventional treatment group (n = 48) and the bisoprolol group (n = 50). [Results] The plasma levels of NT-proBNP in patients with acute myocardial infarction were significantly higher than those in group D> B group> C group> A group> control group (P <0.05, respectively) (P <0.05, P <0.05 respectively). There was a significant difference between the two groups. NT-proBNP decreased significantly in the bisoprolol treatment group. [Conclusion] The plasma levels of NT-proBNP in patients with acute myocardial infarction were significantly increased and related to the infarct site. NT-proBNP in patients with extensive anterior myocardial infarction was significantly increased, and that in patients with posterior inferior myocardial infarction was the lowest. Early use of bisoprolol was effective in reducing plasma NT-proBNP levels in patients with acute myocardial infarction.