BNP、CRP与急性心肌梗死并发恶性室性心律失常的相关分析

金彦彦; 张新勇; 艾辉; 阙斌; 王春梅; 聂绍平

doi:10.13201/j.issn.1001-1439.2014.11.016

BNP、CRP与急性心肌梗死并发恶性室性心律失常的相关分析

- 首都医科大学附属北京安贞医院急诊危重症中心 (北京, 100029)

详细信息

通讯作者: 金彦彦,E-mail:syh2003@sohu.com

中图分类号: R542.2

收稿日期: 2014-02-15

Brain natriuretic peptid,C-reactive protein and acute myocardial infraction with ventricular tachyarrhythmias

- Department of Emergency, Beijing Anzhen Hospital of the Captital Medical University, Beiing, 100029, China

More Information

Corresponding author: JIN Yanyan, E-mail: syh2003@sohu.com

Received Date: 15 February 2014

摘要

摘要: 目的:探讨急性心肌梗死(AMI)患者合并恶性室性心律失常的危险因素。方法:回顾性分析我院接受急诊冠状动脉介入(PCI)的ST段抬高心肌梗死患者322例。分为恶性室性心律失常组(A组)68例和无恶性室性心律失常组(B组)254例。通过观察比较患者的一般临床情况,进行心脏超声检查,检测生化指标、C反应蛋白(CRP)及血浆脑钠肽(BNP)。并将可能的相关因素进行Logist多因素回归分析。结果:两组患者在年龄、性别构成、高血压、陈旧心肌梗死、既往血运重建病史、基础心率、血压等方面具有可比性。但A组患者的空腹血糖、CRP及 BNP水平明显高于B组患者[空腹血糖 (8.83±4.81)mmol/L∶(6.02±2.25) mmol/L, P=0.012;CRP (18.24±12.19)mg/L∶(11.06±10.06) mg/L,P=0.016;BNP(446.04±146.37)pg/L∶(315.01±121.11) pg/L,P=0.009]。Logist多因素回归分析示:BNP、CRP的升高是AMI患者合并恶性室性心律失常的独立危险因素(BNP:OR=1.416,95%CI:0.921~3.012,P=0.021;CRP:OR=1.367,95%CI:1.040~4.312,P=0.015)。结论:AMI患者BNP、CRP水平的升高可能预示发生恶性室性心律失常风险的增加。
- 急性心肌梗死 /
- 恶性室性心律失常 /
- C反应蛋白 /
- 脑钠肽
Abstract: Objective:To explore the risk factors in patients with acute myocardial infarction complicated with malignant ventricular arrhythmia. Method:The study was a retrospective analysis of 322 STEMI patients received primary percutaneous coronary intervention(PPCI) in our hospital from 2010 June to 2012 December. According to malignant ventricular arrhythmia, all patients were divided into: malignant ventricular arrhythmia group (A group), 68 cases; non malignant ventricular arrhythmia group (B group), 254 cases. We observed and compared the two groups patients in general clinical conditions, cardiac ultrasound examination, biochemical indicator detection, C reactive protein (CPR) and plasma brain natriuretic peptide(BNP). Logistic multi-factors regression analysis was performed.Rusult:There were no significant difference between A group with B group in aspects: age,sex, hypertension, old myocardial infarction, previous revascularization, heart rate, blood pressure, et al. There were significant differences in aspects: fasting plasma glucose (8.83±4.81) vs (6.02±2.25) mmol/L, P=0.012;CRP (18.24±12.19) vs (11.06±10.06) mg/L, P=0.016;BNP (446.04±146.37) vs (315.01±121.11) pg/L, P=0.009). The logistic regression analysis demonstated: BNP (OR 1.416, 95% CI 0.921-3.012, P=0.021) and CRP (OR 1.367, 95% CI 1.040-4.312, P=0.015)were independent risk factors of acute myocardial infraction patients with ventricular tachyarrhythmias. Conclusion:BNP and CRP are independent risk factors of acute myocardial infraction patients with malignant ventricular tachyarrhythmias. It may indicate malignant ventricular arrhythmia incidence increase that the level of CRP and BNP elevated in patients with acute myocardial infarction.
- acute myocardial infraction /
- malignant ventricular arrhythmia /
- C reactive protein /
- brain natri-uretic peptid

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参考文献(14)

[1]	FOX K A, ANDERSON F A JR, DABBOUS O H, et al.Intervention in acute coronary syndromes:do patients undergo intervention on the basis of their risk characteristics?The Global Registry of Acute Coronary Events (GRACE)[J].Heart, 2007, 93:177-182.
[2]	KANEKO H, ANZAI T, NAITO K, et al.Role of ischemic preconditioning and inflammatory response in the development of malignant ventricular arrhythmias after reperfused ST-elvation myocardial infarction[J].J Card Fail, 2009, 15:775-781.
[3]	陈俊华, 张淳, 于娜.C1酯酶抑制剂对大鼠急性心肌缺血再灌注损伤的保护作用[J].中华老年心脑血管病杂志, 2011, 13 (9):831-834.
[4]	PEPYS M B, HIRSCHFIELD G M, TENNENT G A, et al.Targeting C-reactive protein for the treatment of cardiovascular disease[J].Nature, 2006, 440:1217-1221.
[5]	CHUNG M K, MARTIN D O, SPRECHER D, et al.C-reactive protein elevation in patients with atrial arrhythmias:inflammatory mechanisms and persistence of atrial fibrillation[J].Circulation, 2001, 104:2886-2891.
[6]	朱妙章, 袁文俊, 吴博威, 等.心血管生理学与临床[M].北京:高等教育出版社, 2004:293-301.
[7]	VYAS A K, GUO H, MOSS A J, et al.Reduction in ventricular tachyarrhythmias with statins in the MADIT II trial[J].J Am Coll Cardiol, 2006, 47:769-773.
[8]	MITCHELL L B, POWELL J L, GILLIS A M, et al.Are lipid-lowering drugs also anti-arrhythmic drugs[J].J Am Coll Cardiol, 2003, 42:81-87.
[9]	ABREU C D, NUNES MDO C, BARBOSA M M, et al.Venticular dyssynchrony and increased BNP levels in right ventricular apical pacing[J].Arq Bras Cardiol, 2011, 97:156-162.
[10]	BLANGY H, SADOUL N, DOUSSET B, et al.Serum BNP, hs-C-reactive protein, procollagen to assess the risk of ventricular tachycardia in ICD recipients after myocardial infarction[J].Europace, 2007, 9:724-729.
[11]	SANJUAN R, BLASCO M L, MARTINEZ-MAICAS H, et al.Acute myocardial infarction:high risk ventricular tachyarrhythmias and admission glucose level in patients with and without diabetes mellitus[J]Curr Diabetes Rev, 2011, 7:126-134.
[12]	MARFELLA R, NAPPO F, DE ANGELIS L, et al.The effect of acute hyperglycaemia on QTc duration in healthy man[J].Diabetologia, 2000, 43:571-575.
[13]	KERSTEN J R, SCHMELING T J, ORTH K G, et al.Acute hyperglycemic abolilshes ischemic preconditioning in vivo[J].Am J Physiol, 1998, 275:H7212-H7215.
[14]	SHIHARA M, TSUTSUI H, TSUCHIHASHI M, et al.In hospital and one year outcomes for patients undergoing percutaneous coronary intervention for acute myocardial infarction[J]Am J Cardiol, 2002, 90:932-936.