李婧, 董丽, 阿荣, 王悦喜. 冠心病患者PCI术后6个月血浆NT-proBNP水平的变化及临床意义[J]. 心脏杂志, 2010, 22(2): 215-219.
    引用本文: 李婧, 董丽, 阿荣, 王悦喜. 冠心病患者PCI术后6个月血浆NT-proBNP水平的变化及临床意义[J]. 心脏杂志, 2010, 22(2): 215-219.
    Changes of plasma NT-proBNP levels and their clinical significance in coronary heart disease patients 6 months after percutaneous coronary intervention[J]. Chinese Heart Journal, 2010, 22(2): 215-219.
    Citation: Changes of plasma NT-proBNP levels and their clinical significance in coronary heart disease patients 6 months after percutaneous coronary intervention[J]. Chinese Heart Journal, 2010, 22(2): 215-219.

    冠心病患者PCI术后6个月血浆NT-proBNP水平的变化及临床意义

    Changes of plasma NT-proBNP levels and their clinical significance in coronary heart disease patients 6 months after percutaneous coronary intervention

    • 摘要: 目的: 观察冠心病患者行经皮冠状动脉介入治疗(PCI)前和6个月以后血浆中氨基末端脑钠尿肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)水平的变化,探讨其临床意义和近期预后价值。方法: 将经冠状动脉造影(CAG)证实的71例冠心病患者,分为PCI组(51例)和对照组(20例),用电化学发光免疫分析法动态观察其血浆NT-proBNP浓度,分别比较PCI组术前、术后即刻、术后6 h、术后24 h和术后6个月血浆NT-proBNP水平的变化情况,以及随访期间PCI组与对照组患者血浆NT-proBNP浓度的变化。经超声心动图检测两组患者住院期间与术后6个月左心室舒张末期内径(LVEDD)和收缩末期内径(LVESD),室间隔(IVSW)与左室后壁厚度(LVPW),左室射血分数(LVEF),左室短轴缩短率(FS)及E/A比值以评价心功能。结果: PCI组术后6个月血浆Log NT-proBNP浓度[(2.0±0.5)ng/L]显著低于术前[(2.4±0.5)ng/L]水平(P<0.05)。对照组患者6个月后血浆Log NT-proBNP浓度[(2.5±0.6)ng/L]明显高于PCI组[(2.0±0.5)ng/L](P<0.05)。比较超声心动图各项指标,PCI组患者术后6个月LVEF[(62±10)%]较术前[(64±10)%]有所下降(P<0.05)。结论: 冠心病患者行PCI术后6个月血浆NT-proBNP水平显著降低,提示血运重建与药物治疗联合可能优于单纯药物治疗,并且NT-proBNP对冠心病患者可能具有近期预后价值,可以指导临床医生早期干预,尽可能降低冠心病发病率和死亡率。

       

      Abstract: AIM: To observe the changes of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in coronary heart disease (CHD) patients before and 6 months after percutaneous coronary intervention (PCI) and to explore their clinical significance and prognostic value. METHODS: Seventy one patients with coronary heart disease confirmed by coronary angiography (CAG) were divided into PCI group (51 cases) and control group (20 cases). Dynamic plasma NT-proBNP concentrations were observed by electrochemiluminescence immunoassay and changes of plasma NT-proBNP concentrations in PCI group were evaluated preoperatively, immediately postoperatively and 6 h, 24 h and 6 months later. We compared the difference of plasma NT-proBNP concentrations between PCI group and control group. Both groups underwent echocardiography during hospitalization and 6 months later, respectively, to examine the left ventricular end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD), interventricular septal wall thickness (IVSW), left ventricular posterior wall thickness (LVPW), left ventricular ejection fraction (LVEF%), left ventricular fraction shortening (FS%) and E/A ratio for the evaluation of cardiac function. RESULTS: Plasma Log NT-proBNP concentrations 6 months after were significantly lower than the preoperative levels in PCI group [(2.0±0.5) ng/L vs. (2.4±0.5) ng/L](P<0.05). Plasma Log NT-proBNP plasma concentrations in control group 6 months after were significantly higher than those in PCI group [(2.5±0.6)ng/L vs. (2.0±0.5)ng/L](P<0.05). Comparison of echocardiographic indicators showed that LVEF% 6 months after was significantly lower than in preoperative PCI group [(64±10)% vs.(62±10)%] (P<0.05). CONCLUSION: Plasma NT-proBNP levels are significantly lower in coronary heart disease patients 6 months after PCI, indicating that revascularization is more effective than drug therapy.

       

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