首页|PCI对老年急性心梗合并心衰患者利钾尿肽、血浆肾素活性和心房钠尿肽水平的影响

PCI对老年急性心梗合并心衰患者利钾尿肽、血浆肾素活性和心房钠尿肽水平的影响

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目的:观察老年急性心肌梗死(AMI)合并心力衰竭患者经皮冠脉内介入治疗(PCI)对外周血中利钾尿肽(KP)、血浆肾素活性(PRA)和心房钠尿肽(ANP)水平的影响.方法:60例老年AMI合并心力衰竭患者随机分为常规保守治疗组(30例)和PCI组(30例),采用放射免疫分析方法测定两组患者入院时、术后1,3,7,14 d和60例健康体检者(正常对照组)外周血中KP,PRA和ANP水平.同时使用二维超声心动图测定患者左心窜射血分数(LVEF).结果:AMI合并心力衰竭患者的血浆KP,PBA和ANP水平较正常对照组显著升高,其中,KP和ANP水平在治疗前与LVEF显著负相关,但PRA水平与LVEF无关,随着病情的好转其水平逐渐降低.在PCI治疗后,PCI组外周血浆中KP、PRA和ANP水平较保守治疗组下降更明显.结论:血浆KP与ANP含最的变化水平在老年AMI合并心力衰竭患者的病理牛理过程中起着一定的作用,且在PCI治疗后仍可用于指导AMI患者的治疗;PCI能显著改善AMI患者的预后.
Effects of percutaneous coronary intervention on kaliuretic peptide,plasma renin activity and atrial natriuretic peptide in elderly patients with acute myocardial infarction and heart failure
AIM:To investigate the levels of the Kaliuretic peptide(KP),Plasma Rennin activity(PRA)and Atrial natriuretic peptide(ANP)in patients with acute myocardial infarction(AMI)and heart failure,and to evaluate the beneficial effects of percutaneous coronary intervention(PCI)on the above variables.METHODS:We studied 60 elderly patients with AMI and Heart failure randomly treated with routine drugs(n=30)or additional PCI(n=30).The levels of plasma KP,PRA and ANP in above elderly patients with AMI and heart failure at the different period of the course and in 60 healthy humans were determined by radioimmunoassay.Simultaneously,the left ventricular ejective fraction(LVEF)of above patients were measured by 2D echoacardiography in properation and postoperation.RESULTS:Compared with control group,the levels of plasma KP,PRA and ANP in elderly patients with AMI and heart failure were significantly increased at each point during the course.There was a significantly negative correlation between KP,ANP and LVEF at 7 d after the treatment,and there were no significant differences of plasma KP level in elderly patients with AMI and heart failure compared with no heart failure of control group.The plasma level of KP,PRA and ANP were decreased more significantly in the PCI group than in the routine group(P<0.05).CONCLUSION:KP and ANP might play an important role in pathogenesis of AMI,and its level still had guided the treatment of AMI even after PCI therapy.PCI is effective to improve the prognosis of elderly patients with AMI and heart failure.

myocardial infarctionacuteheart failurekaliuretic peptideplasma rennin activityatrial natriuretic peptide

唐发宽、华宁、钮炜西、陆宏、肖军、齐帜

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解放军第309医院心血管内科,北京100091

心肌梗死 急性 心力衰竭 利钾尿肽 肾素活性 心房钠尿肽

全军医学科研计划面上项目

01MA216

2009

第四军医大学学报
第四军医大学

第四军医大学学报

CSTPCDCSCD北大核心
影响因子:0.599
ISSN:1000-2790
年,卷(期):2009.30(24)
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