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目的探讨血脑钠肽(BNP)对急性心肌梗死(AMI)诊断、预后评估中的价值。方法选取2015年6月-2017年1月在医院收治的AMI患者132例作为试验组,以同期体检的健康人132例作为对照组,所有受检对象抽取静脉血3 ml,采用荧光免疫法检测BNP浓度;根据观察组AMI患者的Killip分级、梗死部位以及是否ST段抬高进行分组的BNP水平对比。结果观察组患者的BNP水平为(578±31)pg/ml明显高于对照组健康人的(48±13)pg/ml,差异有统计学意义(P<0.05)。随着Killip分级的提高,AMI患者的BNP浓度也随之提高,依次与上一级对比,差异均有统计学意义(P<0.05)。前壁梗死患者的BNP浓度为(592±30)pg/ml高于下壁梗死的(511±21)pg/ml,差异有统计学意义(P<0.05)。ST段抬高性心肌梗死患者BNP水平为(673±22)pg/ml明显高于非ST段抬高性心肌梗死患者的(433±26)pg/ml,差异有统计学意义(P<0.05)。结论 AMI患者伴有BNP水平的提高,而且随着BNP的提高,AMI的严重程度越高,梗死面积大,Killip分级也提高。临床上可将BNP检测作为AMI诊断、预后评估、治疗方案制定中的重要敏感性指标。
Objective To investigate the value of blood brain natriuretic peptide (BNP) in the diagnosis and prognosis of acute myocardial infarction (AMI). Methods A total of 132 AMI patients admitted to the hospital from June 2015 to January 2017 were selected as the experimental group and 132 healthy volunteers were selected as the control group. All the subjects were tested for venous blood by 3 ml. Fluorescence immunoassay BNP levels; according to the observation group of AMI patients Killip grading, infarction and whether the ST segment elevation BNP levels were compared. Results The level of BNP in the observation group was significantly higher than that in the control group (57 ± 31) pg / ml (48 ± 13) pg / ml, the difference was statistically significant (P <0.05). With the increase of Killip grade, BNP concentration in patients with AMI also increased, followed by the level of comparison, the difference was statistically significant (P <0.05). The anterior wall infarction patients BNP concentration (592 ± 30) pg / ml higher than inferior wall infarction (511 ± 21) pg / ml, the difference was statistically significant (P <0.05). The level of BNP in patients with ST elevation myocardial infarction was (673 ± 22) pg / ml, which was significantly higher than that in patients with non-ST elevation myocardial infarction (433 ± 26 pg / ml, P <0.05 ). Conclusions Patients with AMI are associated with elevated BNP levels. With the increase of BNP, the severity of AMI is higher, infarct area is larger and Killip classification is also improved. Clinically, BNP can be used as an important diagnostic indicator for AMI diagnosis, prognosis evaluation and treatment planning.