急性心肌梗死患者脑钠肽变化趋势与IABP球囊导管撤除时机关系的研究

摘要

Objective To discuss the relationship between the change trend of brain natriuretic peptide ( BNP ) and occasion of withdrawing balloon catheter of intra-aortic balloon pumping ( IABP ) in patients with acute myocardial infarction ( AMI ). Methods The patients with AMI ( n = 89 ) treated with IABP were selected and divided, according to the change trend of serum BNP in the occasion of withdrawing balloon catheter, into BNP increasing group ( n = 35 ) and BNP decreasing group ( n = 54 ). The improvement rate, mortality and time of hospital stay were compared between two groups. Results In BNP decreasing group,compared with BNP increasing group, the improvement rate was higher ( 92. 6% vs. 57. 1% ,P <0. 01 ), mortality was lower ( 3.7% vs. 20% ,P < 0.01 ) and time of hospital stay was shorter[( 14. 5 ± 5.7 ) d vs. ( 20.7 ±7. 5 ) d,P <0. 01 ]. Conclusion In the assistant treatment of AMI with IABP, the balloon catheter is withdrawn during the period of serum BNP decreasing and curative effect will be better.%目的 探讨急性心肌梗死患者脑钠肽(BNP)变化趋势与主动脉内球囊反搏术(IABP)辅助治疗球囊导管撤除时机的关系.方法 纳入89例急性心肌梗死并行IABP辅助治疗的患者,根据IABP球囊导管撤除时患者所处的血BNP变化趋势,将患者分为BNP上升段组(n=35)及BNP下降段组(n=54),比较两组患者病情好转率、病死率及住院时间.结果 与BNP上升段组比较,BNP下降段组病情好转率高(92.6% vs.57.1%,P＜0.01)、病死率低(3.7% vs.20%,P＜0.01)、住院时间缩短[(14.5±5.7) d vs.(20.7±7.5) d,P＜0.01].结论 IABP辅助治疗急性心肌梗死,在血BNP处于下降阶段时撤除球囊导管临床治疗效果改善更明显.