急性心肌梗死患者静脉溶栓后早期ST段回落幅度血浆BNP变化观察.docVIP

急性心肌梗死患者静脉溶栓后早期ST段回落幅度与血浆BNP变化的观察 　　作者：杨来宝，吴美凤 作者单位：523980 广东东莞，东莞市沙田医院心内科 　　【摘要】 目的 探讨急性心肌梗死静脉溶栓再通患者1h ST段回落幅度(STR)与血浆BNP水平变化的关系及对预后评估的意义。方法 31例溶栓再通的急性心肌梗死患者按静脉溶栓1h ST段回落幅度分成A和B两组，A组(n=13,STR≥50%)，B组(n=18,STR50%)。测定溶栓前、发病24h和5天时的血浆BNP，进行组内及组间比较。结果 组内溶栓后BNP水平高于溶栓前(P0.05)，发病5天低于发病24h的BNP(P0.05)，溶栓前和发病24h BNP组间比较差异无显著性(P0.05), A组发病5天BNP明显低于B组(P0.01)。结论 急性心肌梗死患者静脉溶栓再通患者早期ST段回落幅度(STR)可反映心肌再灌注治疗后的微循环情况，是预测临床预后和检出高危病人简便而可靠的方法。 　　【关键词】 急性心肌梗死;溶栓治疗;心肌再灌注;ST段;B型钠尿肽(BNP) 　　[中图分类号] R542.2+2 [文献标识码] A [文章编号] 1681-6676(2010)02-0070-04 　　Relations between early ST-segment resolution and BNP in first ST-elevated myocardial infarction patients treated with thrombolysis 　　YANG Lai-bao,WU Mei-feng. 　　Department of Cardiology, Dongguan Shatin Hospital, Dongguan 523980,China 　　[Abstract] Objective To study the relations between early ST-segment resolution and BNP in first ST-elevated myocardial infarction patients undergoing thrombolytic therapy and to evaluate theprognostic significance of early ST-segment solution.Methods ST-segment elevation before and after one hour after thrombolysis were evaluated.The 31 patients were classified into two groups according to early ST-segment resolution：group A(ST-segment resolution ≥50%);group B(ST-segment reselution 50%).In the two groups :The levels of serum BNP after thrombolysis were higher than those before thrombolysis (P0.05), the serum BNP levels on the 5th day were lower than those on the 24th hour (P0.05) . Between the two groups:there was no diference in the BNP both before thrombolysis and on the 24th,however, the serum BNP levels on the 5th day of group A were lower than those of group B(P0.05). Conclusion early ST-segment resolution in first ST-elevated myocardial infarction patients treated with thrombolysis reflect the microcirculaion of the myocardial tissue perfusion and may be a convenient and reliable method for prediction of the prognosis and could be used to detect high risk patients and instruct