B型钠尿肽对急性心肌梗死溶栓后再灌注预测价值.doc

B型钠尿肽对急性心肌梗死溶栓后再灌注预测价值[摘要] 目的：探讨血浆B型钠尿肽（BNP）预测急性心肌梗死（AMI）溶栓治疗后血管再通情况的价值。方法：对112例接受溶栓治疗的AMI患者，同时使用血浆BNP水平和临床间接指征判断血管再通情况，并对它们的结果进行比较。结果：血浆BNP水平对血管未通判断的准确性较临床间接指征高（P=0.000）；敏感性和特异性与后者比较，差异无统计学意义（P=0.069，0.051）；判断血管再通的敏感性、特异性和准确性低于临床间接指征（P=0.000）。结论：对AMI接受溶栓治疗的患者来说，血浆BNP水平可帮助判断血管未通，从而为病情评估和进一步治疗提供依据。 [关键词] 急性心肌梗死（AMI）；溶栓；B型钠尿肽（BNP）；预测 [中图分类号] R541 [文献标识码]A [文章编号]1673-7210（2008）01（c）-038-03 Prognostic value of B-type natriuretic peptide for assessing myocardial reperfusion after thrombolytic therapy on acute myocardial infarction DU Xiao-ben,LIU Ning, LIU Jian-jun (Emergency Department,Affiliated Tongji Hospital of Tongji University,Shanghai200065,China) [Abstract] Objective:To evaluate the prognostic value of B-type natriuretic peptide (BNP) for assessing myocardial reperfusion of the patients with acute myocardial infarction(AMI) who received thrombolytic therapy. Methods:The 112 patients with acute myocardial infarction who received thrombolytic therapy were assessed by plasma level of BNP and indirect clinical index simultaneously to diagnose if the obstructive coronary arteriongraphy had reperfusion. And then, their consequence were compared each other.Results:As diagnosing non-reperfusion,correctness of BNP was higher than that of indirect clinical index (P=0.000), and the sensitivity and specificity were similar with the later (P=0.069, 0.051). Sensitivity, specificity and correctness of BNP were lower than that of indirect clinical index when diagnosing reperfusion(P=0.000). Conclusion:Plasma level of BNP can make for diagnosing non-reperfusion after thrombolysising. So it can offer evidence for assessing their condition and further treatment for the patients with AMI. [Key words] Acute myocardial infarction (AMI); thrombolysis; B-type natriuretic peptide (BNP);Prognosis 如何在冠状动脉造影之前判断血管是否再通是急性心肌梗死（acute myocardial infarction, AMI）溶栓治疗的一个重要环节。本研究通过分析AMI急性期血浆B型钠尿肽(B-type natriuretic peptide, BNP )水平，探讨BNP对接受溶栓治疗的AMI患者血管再通情况的预测价值。现报道如下： 1