| 卫展扬,苏少辉,林玉萍,曾国.重组人脑利钠肽对急性ST段抬高型心肌梗死再灌注后早期心律失常患者治疗效果及保护作用分析.[J].中南医学科学杂志.,2017,(4):378-381. |
| 重组人脑利钠肽对急性ST段抬高型心肌梗死再灌注后早期心律失常患者治疗效果及保护作用分析 |
| Analysis of curative and protective effects of rhBNP patients with early arrhythmia after reperfusion of acute ST elevation myocardial infarction |
| 投稿时间：2016-10-20 修订日期：2017-02-24 |
| DOI：10.15972/j.cnki.43-1509/r.2017.04.012 |
| 中文关键词: ST段抬高型心肌梗死 经皮冠脉介入治疗术 重组人脑利钠肽 再灌注心律失常 |
| 英文关键词:ST elevation myocardial infarction percutaneous coronary intervention brain natriuretic peptide reperfusion arrhythmia |
| 基金项目:东莞市区域性急性心肌梗死现代救治体系的构建(2015108101022) |
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| 中文摘要: |
| 目的 观察重组人脑利钠肽(rhBNP)对急性ST段抬高型心肌梗死(STEMI)再灌注后早期心律失常患者治疗效果及保护作用。方法选择本院行直接经皮冠脉介入治疗术(PCI)的急性STEMI患者68例患者,随机分为两组,每组各34例。对照组给予常规药物治疗,观察组在对照组基础上PCI术前30min给予rhBNP。记录两组再灌注心律失常发生率,PCI术前及术后72天测定血浆脑利钠肽(BNP)及血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、肌酸磷酸激酶同工酶(CK-MB),术后24 h内及术后3个月测定超声心动图测定左室舒张末期直径(LVEDd)、射血分数(EF)。结果用药后,与对照组相比,观察组窦性心动过缓、室性心动过速心室颤动、二度以上房室传导阻滞、窦性停搏、频发室早发生率显著降低；术后,与对照组比较,BNP、CK-MB、CRP、TNF-α、IL-6显著降低,LVEDd减小,EF显著增高。结论rhBNP可有效抑制心室重构,抑制炎性水平过度升高,保护心功能。 |
| 英文摘要: |
| Objective To explore the curative effect and protective effect of recombinant human brain natriuretic peptide (rhBNP) in patients with early arrhythmia after reperfusion of acute ST elevation myocardial infarction (STEMI).MethodsSixty-eight patients with acute STEMI who were treated by direct percutaneous coronary intervention (PCI) in our hospital were randomized into two groups with 34 cases in each group.The control group was treated with routine drugs while the observation group,based on the treatment in the control group,was treated with rhBNP at 30min before PCI,intravenous administration of rhBNP.The incidence rates of reperfusion arrhythmias in both groups were recorded.Before PCI and at 72 day after PCI,plasma brain natriuretic peptide (BNP),serum C reactive protein (CRP),tumor necrosis factor alpha (TNF-α),interleukin 6 (IL-6) and creatine kinase isoenzyme (CK-MB) were determined.At 24 hours and 3 months after operation,the left ventricular end diastolic diameter (LVEDd) and ejection fraction (EF) were determined by echocardiogram.ResultsCompared to the control group,the incidence rates of sinus bradycardia,ventricular tachycardia,ventricular fibrillation,grade two atrioventricular block,sinus arrest and frequent ventricular premature beat in the observation group were lower.The BNP and CK-MB of the observation group after operation were lower than that in the control group.The LVEDd CRP,TNF-α and IL-6 in the observation group after operation was lower while EF was higher.ConclusionRhBNP may effectively inhibit ventricular remodeling, the excessive increase of inflammatory level,protect cardiac heart function. |
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