重组人脑利钠肽在急性心肌梗死PCI后患者心肾功能的保护作用
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摘要
探讨重组人脑利钠肽(rh BNP)在急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)后患者心肾功能的保护作用。选取AMI-PCI后患者100例,依据随机数字表分为rh BNP组和常治组,每组50例,常治组给予常规AMI治疗,rh BNP组在此基础上给予rh BNP治疗,比较两组心肌损伤[氨基末端脑钠肽前体(NT-proBNP)、心肌钙蛋白T(c Tn T)、肌酸激酶同工酶(CK-MB)]、心功能[左心室射血分数(LVEF)、每搏输出量(SV)、心脏指数(CI)]、肾损伤[胱抑素C(CYSC)、β2微球蛋白(β2-MG)]、肾功能[血肌酐(SCR)、尿素氮(BUN)]、不良心脏事件(MACE)、造影剂肾病(RCN)情况。rh BNP组和常治组治疗后NT-proBNP、c Tn T、CK-MB均明显低于治疗前,rh BNP组治疗后SCR、BUN、CYSC、β2-MG明显低于治疗前,rh BNP组治疗后NT-proBNP、c Tn T、CK-MB、SCR、BUN、CYSC、β2-MG明显低于常治组,rh BNP组和常治组治疗后LVEF、SV、CI明显高于治疗前,rh BNP组治疗后LVEF、SV、CI明显高于常治组,rh BNP组MACE、RCN发生率明显低于常治组,差异有统计学意义(P <0. 05)。rh BNP可有效减少AMI-PCI术后患者心肾损伤,有利于保护患者的心肾功能及减少MACE、RCN。
To discuss the protective effect of recombinant human brain natriuretic peptide( rh BNP) on the cardiac and renal function in patients with acute myocardial infarction( AMI) after percutaneous coronary intervention( PCI),100 patients with AMI after PCI were selected; according to the random number table method,they were divided into rh BNP group and routine treatment group,50 cases in each group. The routine treatment group was given routine AMI treatment,and the rh BNP group was given rh BNP treatment on this basis. The myocardial injury [precursor of amino-terminal brain natriuretic peptide( NT-proBNP),cardiac troponin T( c Tn T),creatine kinase isoenzyme( CK-MB) ],cardiac function [left ventricular ejection fraction( LVEF),stroke volume( SV),cardiac index( CI) ],renal injury [photostatin C( CYSC),beta 2-microglobulin( beta 2-MG) ],renal function [creatinine( SCR),urea nitrogen( BUN) ],adverse cardiac events( MACE),radiographic contrast nephropathy( RCN) were compared between the two groups. The after treatment NT-proBNP,c Tn T,CK-MB in the rh BNP group and routine treatment group were significantly lower than those in the before treatment,the after treatment SCR,BUN,CYSC,beta 2-MG in the rh BNP group were significantly lower than those in the before treatment,the after treatment NT-proBNP,c Tn T,CK-MB,SCR,BUN,CYSC,beta 2-MG in the rh BNP group were significantly lower than those in the routine treatment group,the after treatment LVEF,SV,CI in the rh BNP group and routine treatment group were significantly higher than those in the before treatment; the after treatment LVEF,SV,CI in the rh BNP group were significantly higher than those in the routine treatment group; the incidence of MACE and RCN in the rh BNP group was significantly lower than that in the routine treatment group; the difference was statistically significant( P < 0. 05). rh BNP can effectively reduce the heart and kidney injury in patients with AMI after PCI,which is beneficial to protect the heart and kidney function and reduce the MACE,RCN of patients.
To discuss the protective effect of recombinant human brain natriuretic peptide( rh BNP) on the cardiac and renal function in patients with acute myocardial infarction( AMI) after percutaneous coronary intervention( PCI),100 patients with AMI after PCI were selected; according to the random number table method,they were divided into rh BNP group and routine treatment group,50 cases in each group. The routine treatment group was given routine AMI treatment,and the rh BNP group was given rh BNP treatment on this basis. The myocardial injury [precursor of amino-terminal brain natriuretic peptide( NT-proBNP),cardiac troponin T( c Tn T),creatine kinase isoenzyme( CK-MB) ],cardiac function [left ventricular ejection fraction( LVEF),stroke volume( SV),cardiac index( CI) ],renal injury [photostatin C( CYSC),beta 2-microglobulin( beta 2-MG) ],renal function [creatinine( SCR),urea nitrogen( BUN) ],adverse cardiac events( MACE),radiographic contrast nephropathy( RCN) were compared between the two groups. The after treatment NT-proBNP,c Tn T,CK-MB in the rh BNP group and routine treatment group were significantly lower than those in the before treatment,the after treatment SCR,BUN,CYSC,beta 2-MG in the rh BNP group were significantly lower than those in the before treatment,the after treatment NT-proBNP,c Tn T,CK-MB,SCR,BUN,CYSC,beta 2-MG in the rh BNP group were significantly lower than those in the routine treatment group,the after treatment LVEF,SV,CI in the rh BNP group and routine treatment group were significantly higher than those in the before treatment; the after treatment LVEF,SV,CI in the rh BNP group were significantly higher than those in the routine treatment group; the incidence of MACE and RCN in the rh BNP group was significantly lower than that in the routine treatment group; the difference was statistically significant( P < 0. 05). rh BNP can effectively reduce the heart and kidney injury in patients with AMI after PCI,which is beneficial to protect the heart and kidney function and reduce the MACE,RCN of patients.
引文
[1] Reibis R,Jannowitz C,Halle M,et al. Management and outcomes of patients with reduced ejection fraction after acute myocardial infarction in cardiac rehabilitation centers[J]. Curr Med Res Opin,2015,31(2):211-219.
[2]潘洁丽,郏国炯,王萌.中药制剂复方丹参滴丸对急性心肌梗死患者体内核因子-KBp65介导的炎症反应的影响[J].药物生物技术,2017,24(2):120-123.
[3]吴春涛,马士新.重组人脑利钠肽对急性心肌梗死经皮冠状动脉介入治疗术后心力衰竭患者心肌酶、梗死面积的影响[J].中国介入心脏病学杂志,2016,24(7):394-397.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,38(5):380-393.
[5] Reibis R,Jannowitz C,Halle M,et al. Management and out-comes of patients with reduced ejection fraction after acute myo-cardial infarction in cardiac rehabilitation centers[J]. Curt Med Res Opin,2015,31(2):211-219.
[6]袁莹,田原,胡小莹,等.行急诊经皮冠状动脉介入治疗患者血浆大内皮素水平与术后对比剂诱导急性肾损伤的相关性分析[J].中国循环杂志,2017,32(7):633-637.
[7] Chitose T,Sugiyama S,Sakamoto K,et al. Effect of a hydro-philic and a hydrophot)ic statin on cardiac salvage after ST-ele-vated acute myocardial infarction a pilot study[J]. Atherosclerosis,2014,237(1):251-258.
[8]邹筱冬,吴同果,崔进,等.早期强化瑞舒伐他汀治疗对急性冠状动脉综合征患者经皮冠状动脉介入术后心肾功能的影响[J].广西医学,2014,36(6):760-763.
[9] Takaya Y,Kumasaka R,Arakawa T,et al. Impact of cardiac rehabilitation on renal function in patients with and without chronic kidney disease after acute myocardial infarction[J]. Cite J,2014,78(2):377-384.
[10]陈西洲.重组人脑利钠肽辅助介入治疗对急性心肌梗死合并心源性休克患者预后的影响[J].海南医学院学报,2016,22(2):133-137.
[11] Kleczy6 ski P,Legutko J,Rakowski T,et al. Predictive utility of NT-pro BNP for infarct size and left ventricle function after acute myocardial infarction in long-term follow-up[J]. Dis Markers,2013,34(3):199-204.
[12]何战斌,陈圆圆,樊旺祥,等.重组人脑利钠肽对老年急性心肌梗死患者经皮冠状动脉介入治疗后心功能及组织灌注的影响[J].安徽医学,2018,39(8):955-959.
[13] Sangaralingham SJ,Burnett JC Jr,Mc Kie PM,et al. Rationale and design of a randomized,double--blind,placebo-controlled clinical trial to evaluate the efficacy of B--type natriuretic pep-tide for the preservation of left ventricular function after anteri-ormyoeardial infarction[J]. J Card Fail,2013,19(8):533-539.
[14]王轩,崔杰,崔晓云,等.复方丹参注射液对急性ST段抬高心肌梗死患者PCI术后肾功能损害的影响[J].现代中西医结合杂志,2018,27(10):1035-1037.
[15]赵倩,卓杨,卞玲,等.前列地尔对急性心梗合并糖尿病肾病PCI患者肾功能的疗效[J].心血管康复医学杂志,2017,26(3):281-284.
[2]潘洁丽,郏国炯,王萌.中药制剂复方丹参滴丸对急性心肌梗死患者体内核因子-KBp65介导的炎症反应的影响[J].药物生物技术,2017,24(2):120-123.
[3]吴春涛,马士新.重组人脑利钠肽对急性心肌梗死经皮冠状动脉介入治疗术后心力衰竭患者心肌酶、梗死面积的影响[J].中国介入心脏病学杂志,2016,24(7):394-397.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,38(5):380-393.
[5] Reibis R,Jannowitz C,Halle M,et al. Management and out-comes of patients with reduced ejection fraction after acute myo-cardial infarction in cardiac rehabilitation centers[J]. Curt Med Res Opin,2015,31(2):211-219.
[6]袁莹,田原,胡小莹,等.行急诊经皮冠状动脉介入治疗患者血浆大内皮素水平与术后对比剂诱导急性肾损伤的相关性分析[J].中国循环杂志,2017,32(7):633-637.
[7] Chitose T,Sugiyama S,Sakamoto K,et al. Effect of a hydro-philic and a hydrophot)ic statin on cardiac salvage after ST-ele-vated acute myocardial infarction a pilot study[J]. Atherosclerosis,2014,237(1):251-258.
[8]邹筱冬,吴同果,崔进,等.早期强化瑞舒伐他汀治疗对急性冠状动脉综合征患者经皮冠状动脉介入术后心肾功能的影响[J].广西医学,2014,36(6):760-763.
[9] Takaya Y,Kumasaka R,Arakawa T,et al. Impact of cardiac rehabilitation on renal function in patients with and without chronic kidney disease after acute myocardial infarction[J]. Cite J,2014,78(2):377-384.
[10]陈西洲.重组人脑利钠肽辅助介入治疗对急性心肌梗死合并心源性休克患者预后的影响[J].海南医学院学报,2016,22(2):133-137.
[11] Kleczy6 ski P,Legutko J,Rakowski T,et al. Predictive utility of NT-pro BNP for infarct size and left ventricle function after acute myocardial infarction in long-term follow-up[J]. Dis Markers,2013,34(3):199-204.
[12]何战斌,陈圆圆,樊旺祥,等.重组人脑利钠肽对老年急性心肌梗死患者经皮冠状动脉介入治疗后心功能及组织灌注的影响[J].安徽医学,2018,39(8):955-959.
[13] Sangaralingham SJ,Burnett JC Jr,Mc Kie PM,et al. Rationale and design of a randomized,double--blind,placebo-controlled clinical trial to evaluate the efficacy of B--type natriuretic pep-tide for the preservation of left ventricular function after anteri-ormyoeardial infarction[J]. J Card Fail,2013,19(8):533-539.
[14]王轩,崔杰,崔晓云,等.复方丹参注射液对急性ST段抬高心肌梗死患者PCI术后肾功能损害的影响[J].现代中西医结合杂志,2018,27(10):1035-1037.
[15]赵倩,卓杨,卞玲,等.前列地尔对急性心梗合并糖尿病肾病PCI患者肾功能的疗效[J].心血管康复医学杂志,2017,26(3):281-284.