Objective To investigate the relation between brain natriuretic peptide(BNP) levels on the first 24 hours after ST-segment elevation acute myocardial infarction(STEMI) and the development of left ventricular remodeling at 6-month follow-up. Method Consecutive Seventy patients with first STEMI, successfully reperfused by primary percutaneous coronary intervention(PCI) within 12 hours of symptom onset, were included in this study. BNP plasma concentration levels were measured by fluorescence immunoassay at 24 h from onset, and at I-and 6-month follow-up. Left ventricular diastolic volume、left ventricular systolic volume and left ejection fraction were assessed using echoeardiography on the third day after the onset of STEMI and at 1-and 6-month follow-up. observe the relation between the left ventricular remodeling at 6-month follow-up and plasma BNP levels on admission. Result 27％ of patients developed LV remodeling at 6-month follow-up. BNP levels on admission and at follow-up were significantly higher in patients who developed LV remodeling at 6 months. After adjusting for age, hypertension, diabetes, infarct location, E-wave deceleration time and the LV ejection fraction, BNP on admission independently correlated with LV remodeling( r = -0. 621 ,P =0.000). Conclusion Determination of plasma BNP levels on admission can be helpful in evaluating the development of left ventricular remodeling for patients with fist STEMI underwent PCI.%目的 探讨首发急性ST段抬高性心肌梗死患者心肌梗死发作24小时血浆B型利钠肽(BNP)水平与心肌梗死后6个月左窒重构的相关性.方法 选择首发急性ST段抬高性心肌梗死患者70例,发病后12小时之内均成功接受急诊经皮冠状动脉介入治疗.采用荧光测定法测定患者心梗急性发作24小时(早期)、第30天及6个月时血浆BNP水平;超声心动图测定左室舒张未期容积、左室收缩未期容积并计算左室射血分数.随访6个月,观察心梗后早期BNP水平与心梗后6个月左室重构的关系.结果 27%的患者发生了左室重构,左室重构组患者早期及随访30天、6个月血浆BNP水平均明显高于无左室重构组患者.在校正了年龄、高血压病、糖尿病、心梗部位、E峰减速时间及左室射血分数等影响左室重构的因素后,心梗后早期血浆BNP水平与心梗后6个月左室重构独立相关.结论 早期测定血浆BNP水平有助于评价首发急性ST段抬高性心肌梗死患者急诊冠脉介入术后左心室重构,对判断预后有一定价值.
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