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目的:探讨急性心肌梗死(AMI)早期血浆脑钠肽(BNP)水平与不同部位梗死急性期及6个月左室功能及重塑的关系。方法:486例AMI患者分为:A组,前、侧壁组,B组:下、后壁组;根据BNP是否大于180 ng/L将A、B 2组分别分为A1组、B1组(≥180 ng/L),A2组、B2组(<180 ng/L)。所有患者,均急诊行冠状动脉介入治疗及左室造影检查,记录左室功能及左室重塑参数,6个月后复查。结果:急性期A组室壁运动障碍较B组明显,室壁瘤比率高;A1组心功能指标及左室室壁运动积分(LVWMS)均差于A2组;B1组LVWMS高于B2组。术后6个月复查,A1组左室功能及室壁运动改善情况均差于其余3组,B2组改善最明显。AMI早期BNP浓度与左室射血分数呈负相关,6个月后复查,A组中二者仍呈负相关。结论:AMI早期BNP浓度对于梗死心功能状态及心室重构有重要的预测作用,尤其是前壁心肌梗死这种作用可持续到心肌梗死后6个月。
Objective: To investigate the relationship between early plasma levels of brain natriuretic peptide (BNP) and acute left ventricular infarction (AMI) and acute left ventricular remodeling at 6 months in acute myocardial infarction (AMI). Methods: A total of 486 patients with AMI were divided into group A, anterior wall and lateral wall, group B: inferior wall and posterior wall, group A and B 2 were divided into group A1 and group B1 according to whether BNP was greater than 180 ng / ≥180 ng / L), A2 group, B2 group (<180 ng / L). All patients underwent emergency treatment of coronary intervention and left ventricular angiography, recording left ventricular function and left ventricular remodeling parameters, 6 months after the review. Results: Acute wall motion impairment was more obvious in group A than in group B, and the ratio of ventricular aneurysm was higher. The cardiac function index and left ventricular wall motion score (LVWMS) in group A were worse than that in group A2. The LVWMS in group B1 was higher than that in group B2. 6 months after the review, A1 group left ventricular function and ventricular wall motion improvement are worse than the other three groups, B2 group the most obvious improvement. The concentration of BNP in early stage of AMI was negatively correlated with left ventricular ejection fraction, and after 6 months, there was still a negative correlation between the two groups. CONCLUSION: The early BNP concentration in AMI has important predictive value for the functional status and ventricular remodeling in infarction. Especially, the effect of anterior myocardial infarction can be sustained for 6 months after myocardial infarction.