刘志,华琦,刘芦姗,秦俭,李东宝

• 1:首都医科大学宣武医院心脏科
• 2:中国康复中心急诊科
• 3:首都医科大学宣武医院急诊科

摘要(Abstract)：

目的探讨急诊介入手术对急性ST段抬高心肌梗死患者血浆B型钠尿肽(BNP)水平的影响。方法选择2008年1月至12月因急性ST段抬高心肌梗死收入我院心内科重症监护室的193例患者,所有患者根据病史在距离发病18 h行床边即时BNP检测。根据是否行急诊经皮冠状动脉介入治疗(PCI)将患者分为急诊PCI组(92例)和药物保守治疗组(101例),再将急诊PCI组根据发病来院时间,分为两个亚组,Ⅰ组(发病时间≤3 h,n=42)和Ⅱ组(发病时间3～6 h,n=50),比较二者BNP水平。结果急诊PCI组的BNP水平明显低于药物保守治疗组,差异有统计学意义(261.0±410.9 ng/L比921.5±1126.7 ng/L,P<0.01)。闭塞血管开通越早,BNP降低越明显。术后血流未达TIMI 3级的患者BNP水平不能显著降低。结论尽早地开通梗死相关血管,恢复梗死相关动脉TIMI 3级血流再灌注,可有效地挽救濒死的心肌,减轻心室重构,保护心功能,改善患者预后。

关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;心钠素

Abstract:

Keywords:

基金项目(Foundation): 北京自然科学基金资助(7072032)

作者(Author): 刘志,华琦,刘芦姗,秦俭,李东宝

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