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脑利钠肽在急性心肌梗死中的释放。

Brain natriuretic peptide release in acute myocardial infarction.

机构信息

Clinic for Heart Disease and Rheumatism, Clinical Center, University of Sarajevo, Bolnička, Sarajevo, Bosnia and Herzegovina.

出版信息

Bosn J Basic Med Sci. 2012 Aug;12(3):164-8. doi: 10.17305/bjbms.2012.2470.

Abstract

Brain natriuretic peptide (BNP) is released from ventricular myocites due to their stretching and volume overload. In heart failure there is BNP release. Aim of this study was to observe BNP release in acute myocardial infarction (AMI). We measured BNP in 75 patients with AMI. Control group (n=61) was similar by age and gender to AMI group. We found statistically significant elevation of BNP compared to controls (462.875 pg/ml vs 35.356 pg/ml, p< 0.001). Patients with severe systolic dysfunction had the highest BNP levels, while patients with the preserved systolic function had the lowest BNP levels (Group with EF< 30% BNP= 1129.036 pg/ml vs Group with EF31-40 % BNP= 690.177 pg/ml vs Group with EF 41-50% BNP= 274.396 pg/ml vs Group with EF> 51% BNP= 189.566 pg/ml, p< 0.001). We found statistically significant light positive correlation between BNP and left ventricle end-diastolic diameter (LVDd) (r= 0.246, p<0.05). and real positive correlation between BNP and peak troponin levels (r= 0.441, p < 0.05). BNP levels were higher in anteroseptal allocation of AMI compared to inferior allocation (835.80 pg/ml vs 243.03 pg/ml, p< 0.001) and in patients who were treated with heparin compared to fibrinolitic therapy (507.885 pg/ml vs 354.73 pg/ml, p< 0.05). BNP is elevated in AMI and is a quantitative biochemical marker related to the extent of infarction and the left ventricle systolic dysfunction. Besides echocardiographic calculation, elevation of BNP could be used for quick and easy determination of the left ventricle systolic dysfunction.

摘要

脑利钠肽(BNP)是由于心室肌细胞的拉伸和容量超负荷而从心室肌细胞中释放出来的。心力衰竭时会释放 BNP。本研究的目的是观察急性心肌梗死(AMI)中 BNP 的释放。我们测量了 75 例 AMI 患者的 BNP。对照组(n=61)在年龄和性别上与 AMI 组相似。与对照组相比,我们发现 BNP 有统计学意义的升高(462.875 pg/ml 与 35.356 pg/ml,p<0.001)。收缩功能严重障碍的患者 BNP 水平最高,而收缩功能保留的患者 BNP 水平最低(EF<30%的 BNP=1129.036 pg/ml 与 EF31-40%的 BNP=690.177 pg/ml 与 EF41-50%的 BNP=274.396 pg/ml 与 EF>51%的 BNP=189.566 pg/ml,p<0.001)。我们发现 BNP 与左心室舒张末期直径(LVDd)之间存在统计学上的轻度正相关(r=0.246,p<0.05)。而且 BNP 与肌钙蛋白峰值水平之间存在真正的正相关(r=0.441,p<0.05)。与下壁梗死相比,前间隔梗死的 AMI 患者 BNP 水平更高(835.80 pg/ml 与 243.03 pg/ml,p<0.001),与接受肝素治疗的患者相比,接受纤维蛋白溶解治疗的患者 BNP 水平更高(507.885 pg/ml 与 354.73 pg/ml,p<0.05)。AMI 时 BNP 升高,是与梗死范围和左心室收缩功能障碍相关的定量生化标志物。除了超声心动图计算外,BNP 升高可用于快速简便地确定左心室收缩功能障碍。

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