[1]龙继贤,高文妹.ST段抬高型急性心肌梗死早期脑钠肽水平变化及各个时间点检测对心力衰竭的诊断价值[J].陕西医学杂志,2019,(5):595-598,602.
　LONG Jixian,GAO Wenmei..The change of brain natriuretic peptide(BNP)concentration in the early stage of STsegment elevationacute myocardial infarction and the diagnostic value of BNP at different time points for heart failure at that time[J].,2019,(5):595-598,602.
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ST段抬高型急性心肌梗死早期脑钠肽水平变化及各个时间点检测对心力衰竭的诊断价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年5期
页码:
595-598,602
栏目:
临床研究
出版日期:
2019-05-05

文章信息/Info

Title:
The change of brain natriuretic peptide(BNP)concentration in the early stage of STsegment elevationacute myocardial infarction and the diagnostic value of BNP at different time points for heart failure at that time
文章编号:
DOI: 10.3969/j.issn.10007377.2019.05.015
作者:
龙继贤; 高文妹
上海市徐汇区大华医院急诊医学科（上海200237）
Author(s):
LONG Jixian; GAO Wenmei.
Emergency Department,Dahua Hospital of Shanghai Xuhui District（Shanghai 200237）
关键词:
脑钠肽; ST段抬高型急性心肌梗死; 心力衰竭; 相关性; 诊断; 对比研究
Keywords:
Key words Brain natriuretic peptide;  STsegment elevation acute myocardial infarction;  Heart failure;  Correlation;  Diagnose; Comparative study
分类号:
R541.4
文献标志码:
A
摘要:
摘 要 目的：研究ST段抬高型急性心肌梗死(STEMI)患者早期脑钠肽(BNP)水平变化情况，分析各个时间点BNP水平对心力衰竭的诊断价值。方法：118例STEMI患者作为研究对象。根据Killip分级分为心力衰竭组(n=42)和非心力衰竭组(n=76)。分析两组患者不同时间点的BNP水平情况和STEMI患者BNP水平的影响因素，分析不同时间点BNP水平与Killip分级的关系。结果：心力衰竭患者在发病6、12、24、48 h时BNP水平分别为(52.96±10.12) pg/ml、(172.43±25.38) pg/ml、(471.24±51.72) pg/ml和(374.69±33.42) pg/ml，均明显高于非心力衰竭患者的(12.58±2.69) pg/ml、(75.82±12.36) pg/ml、(179.27±20.64) pg/ml和(118.42±19.76) pg/ml（均P＜0.05）。发病6～24 h,所有患者BNP水平随着时间的延长而增高，发病24~48 h，所有患者BNP水平随着时间的延长而降低（均P＜0.05）。等级Logistic回归分析显示，Killip分级较低、前壁心肌梗死、男性和发病至球囊扩张时间较短是STEMI患者BNP水平较低的影响因素（均P＜0.05）。BNP浓度在发病6、12 h时与Killip分级呈较弱正相关，发病24、48 h时,BNP浓度与Killip分级呈较强正相关（均P＜0.05）。结论：BNP水平随着STEMI患者发病时间的延长而升高，约24 h达峰值。BNP在STEMI患者发病≤12 h及＞24 h对心力衰竭的诊断价值较低，STEMI患者发病12～24 h BNP对心力衰竭的诊断价值较高。
Abstract:
Abstract Objective:To study the changes of early brain natriuretic peptide(BNP) concentration in STsegment elevation acute myocardial infarction(STEMI) patients, and to analyze the diagnostic value of BNP concentration at each time point for heart failure at that time. Methods:118 cases STEMI admitted to our hospital from August 2015 to August 2017 were included in the study.They were divided into heart failure group(n=42) and non heart failure group(n=76).The levels of BNP at different time points in 2 groups were analyzed, and the influencing factors of BNP level in STEMI patients were analyzed, and the relationship between BNP level and Killip grading at different time points was analyzed. Results: The levels of BNP in STEMI patients with heart failure were (52.96±10.12) pg/ml, (172.43±25.38) pg/ml, (471.24±51.72) pg/ml and (374.69±33.42) pg/ml at the onset of 6,12,24 and 48 h, which were significantly higher than those of non heart failure STEMI patients (12.58±2.69)pg/ml, (75.82±12.36)pg/ml, (179.27±20.64)pg/ml and (118.42±19.76) pg/ml（all P＜0.05）. The levels of BNP had increased with time in all patients at onset of 6～24 h, and the BNP levels had decreased at onset of 24～48 h（all P＜0.05）. Logistic regression analysis showed that lower Killip grade, anterior wall myocardial infarction, male and shorter time to onset to balloon expansion are factors influencing lower BNP levels in STEMI patients（all P＜0.05）. BNP level was positively correlated with Killip grade at onset of 6～12 h, and BNP concentration was positively correlated with Killip grade at onset of 24～48 h（all P＜0.05）.Conclusion:The level of BNP increasing with the prolongation of the onset time of STEMI, and reaches the highest value at onset of 24 h. The value of BNP is lower in the〖LM〗 diagnosis of STEMI combined with heart failure within 12 h of STEMI. The diagnostic value of onset time of 12～24 h and >24 h BNP in STEMI combined with heart failure is significantly higher than that of onset time of 24 h.

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更新日期/Last Update: 2019-05-07