老年急性前壁心肌梗死患者急诊经皮冠状动脉介入术前主动脉内球囊反搏联合术后重组人脑利钠肽对心室重构的影响

doi:10.3969/j.issn.1006-5725.2025.05.012

Abstract

Abstract:

Objective The effect of intra?aortic balloon counterpulsation combined with recombinant human brain natriuretic peptide （rhBNP） treatment on ventricular remodeling after percutaneous coronary intervention （PCI） in elderly patients with acute anterior wall myocardial infarction. Methods A retrospective analysis was conducted on 66 elderly patients with acute anterior myocardial infarction who underwent emergency PCI in our hospital from January 2018 to June 2023. They were divided into a control group （n = 32） who underwent PCI + rhBNP， and a study group （n = 32） who underwent PCI+rhBNP+intra?aortic balloon counterpulsation. Blood pressure， lactic acid level， mechanical complications， ventricular remodeling， inflammatory factors， myocardial enzymology， ox?LDL level were detected and compared between the two groups. Results Before treatment， Lactic acid， diastolic blood pressure， systolic blood pressure， left ventricular end?systolic diameter （LVESD）， left ventricular end?diastolic diameter （LVEDD）， left ventricular posterior wall thickness （LVPWT）， left ventricular remodeling index （LVRI）， left ventricular ejection fraction （LVEF）， homocysteine （Hcy）， interleukin?6 （IL?6） and myocardial troponin were compared between the two groups. Myocardial troponin T （cTnT）， lactate dehydrogenase （LDH）， creatine kinase isoenzyme （CK?MB）， oxidized low density lipoprotein （ox?LDL） levels （P > 0.05）； At 3 months follow?up after discharge， the levels of lactic acid， LVESD， LVEDD， LVPWT， LVRI， Hcy， IL?6， cTnT， LDH， CK?MB and ox?LDL were decreased， and the levels were lower in the study group， and the levels of diastolic blood pressure， systolic blood pressure and LVEF were increased， and the levels were higher in the study group （P < 0.05）. The proportion of mechanical complications between the two groups before and after treatment were compared （P > 0.05）. Conclusion In elderly patients with acute anterior myocardial infarction after emergency PCI， intra?aortic balloon counterpulsation combined with rhBNP could alleviate ventricular remodeling， myocardial injury， reduce inflammatory injury， improve oxidative stress response， and regulate tissue perfusion.

Key words: intra?aortic balloon counterpulsation, recombinant human brain natriuretic peptide, acute anterior myocardial infarction, percutaneous coronary intervention, ventricular remodeling

CLC Number:

R542.2

Shengbo LI,Ling FENG,Beibei CHEN,Fang YAO,Yongsheng XING,Yanbin. LIU. Effect of intra⁃aortic balloon counterpulsation combined with rhBNP on ventricular remodeling in elderly patients with acute anterior myocardial infarction before emergency PCI[J]. The Journal of Practical Medicine, 2025, 41(5): 699-703.

Figures/Tables 6

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Tab.6

References 25

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一般资料	对照组（n=32）	研究组（n=34）	t/χ ² 值	P值
性别			0.184	0.668
男	22（68.75）	25（73.53）
女	10（31.25）	9（26.47）
年龄（x ± s）/岁	66.30 ± 4.08	66.23 ± 4.14	0.159	0.723
体质量指数（x ± s）/（kg/m²）	24.96 ± 1.37	25.01 ± 1.35	0.045	0.823
发病至入院时间（x ± s）/h	6.85 ± 1.23	9.86 ± 1.25	0.069	0.805
NYHA心功能分级			0.049	0.826
Ⅱ级	5（15.63）	6（17.65）
Ⅲ级	22（68.75）	23（67.65）
Ⅳ级	5（15.63）	5（14.71）
基础疾病
高脂血症	7（21.88）	8（23.53）	0.026	0.873
糖尿病	5（15.63）	5（14.71）	0.011	0.917
高血压	6（18.75）	7（20.59）	0.035	0.851

组别	例数	血乳酸/（mmol/L）		舒张压/mmHg		收缩压/mmHg		机械并发症/［例（%）］
组别	例数	治疗前	出院后3个月	治疗前	出院后3个月	治疗前	出院后3个月	治疗前	出院后3个月
对照组	32	16.10 ± 1.26	10.61 ± 1.01	39.01 ± 3.26	56.12 ± 5.27	72.12 ± 6.31	95.45 ± 9.88	30（93.75）	3（9.38）
研究组	34	15.99 ± 1.28	8.12 ± 0.83	38.97 ± 3.25	61.96 ± 6.14	72.30 ± 6.28	106.25 ± 11.36	34（100.00）	2（5.88）
t值		0.352	10.970	0.050	4.134	0.116	4.110	2.191	0.287
P值		0.726	< 0.001	0.960	< 0.001	0.908	< 0.001	0.139	0.592

组别	例数	LVESD/mm		LVEDD/mm		LVPWT/mm		LVRI/（g/mL）		LVEF/%
组别	例数	治疗前	出院后 3个月	治疗前	出院后 3个月	治疗前	出院后 3个月	治疗前	出院后 3个月	治疗前	出院后 3个月
对照组	32	46.12 ± 4.35	40.20 ± 3.12	62.23 ± 5.30	52.14 ± 4.04	14.30 ± 1.38	10.25 ± 1.05	3.03 ± 0.35	2.21 ± 0.25	29.63 ± 2.76	42.99 ± 4.20
研究组	34	46.08 ± 4.33	34.55 ± 2.01	61.98 ± 5.23	17.36 ± 3.18	14.29 ± 1.36	8.77 ± 1.01	3.02 ± 0.36	1.82 ± 0.15	30.02 ± 2.89	48.01 ± 5.17
t值		0.152	8.798	0.362	39.161	0.028	5.836	0.102	7.738	0.560	4.314
P值		0.876	< 0.001	0.718	< 0.001	0.978	< 0.001	0.920	< 0.001	0.578	< 0.001

组别	例数	Hcy/（μmol/L）		IL-6/（ng/L）
组别	例数	治疗前	出院后3个月	治疗前	出院后3个月
对照组	32	17.88 ± 1.61	13.01 ± 1.10	16.02 ± 1.48	10.60 ± 1.05
研究组	34	17.91 ± 1.60	10.28 ± 1.00	15.99 ± 1.50	8.02 ± 0.70
t值		0.505	10.560	0.116	11.810
P值		0.563	< 0.001	0.903	< 0.001

组别	例数	cTnT/（μg/L）		LDH/（U/L）		CK-MB/（U/L）
组别	例数	治疗前	出院后3个月	治疗前	出院后3个月	治疗前	出院后3个月
对照组	32	1.36 ± 0.12	0.41 ± 0.05	356.12 ± 36.01	240.42 ± 22.89	212.01 ± 20.21	92.14 ± 10.73
研究组	34	1.38 ± 0.11	0.16 ± 0.02	357.30 ± 35.44	205.01 ± 18.14	211.76 ± 20.17	80.25 ± 6.00
t值		0.010	26.963	0.842	6.987	0.389	5.599
P值		0.920	< 0.001	0.401	< 0.001	0.711	< 0.001

Effect of intra⁃aortic balloon counterpulsation combined with rhBNP on ventricular remodeling in elderly patients with acute anterior myocardial infarction before emergency PCI

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组别	例数	治疗前	出院后3个月
对照组	32	27.12 ± 2.58	16.23 ± 1.50
研究组	34	27.08 ± 2.60	12.01 ± 1.01
t值		0.028	13.479
P值		0.976	< 0.001

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