| Objective:To compare the effects of intravenous rh-BNP on cardiac function in patients with acute anterior myocardial infarction within 6 hours and within 6-12 hours after percutaneous coronary intervention.Methods: Patients were chosen from the Chest Pain Center of the Second Hospital of Hebei Medical University from December 2017 to December 2018.There were 64 patients with acute anterior myocardial infarction who underwent coronary angiography plus percutaneous coronary intervention(CAG+PCI)within 12 hours.All of them were divided into three groups according to the different times from attack to check-in.The patients with rh-BNP within 6 hours after attack were group A(26 cases),the patients with rh-BNP within 6-12 hours after attack were group B(22 cases)and the patients with intravenous nitroglycerin within 6 hours after attack were group C(16 cases).Moreover,the basic information of all patients were collected.The incidence of major cardiac adverse events on the seventh day and the first month after surgery were compared among the three groups.All data were statistically processed using SPSS 22.0 software,and a P value <0.05 considered statistically different.Results: A total of 64 eligible patients were enrolled,including 26(Males accounted for 84%)in group A,22(Males accounted for 91%)in group B and 16(Males accounted for 93%)in group C.No major adverse cardiac events occurred among three groups during hospitalization.There were no MACE events when patients in group A have left hospital for one month.However,there was one patient in group B re-hospitalized for heart failure.And 4 patients in group C,short of breath,were treated with continuous intravenous administration pumping of rh-BNP for 72 hours and then they got better obviously.Also,there was 2 patients with heart failure in group C re-admitted to hospital when they have left hospital for one month.There were no statistical significance between the two groups in baseline data and related laboratory indicators.The LVEF of the three groups of patients increased on the 7th day,group A>group B>group C,the difference was not statistically significant.LVEDV increased within 24 hours after attack,group A>group B>group C,the difference was not statistically significant.LVESV decreased within 24 hours after attack,group A > group B > group C,the difference was not statistically significant.Heart rate comparison: The heart rate of group C was significantly lower than that of group A and group B at 24 hours after treatment.The difference was not statistically significant.At 72 hours of treatment,the heart rate of the three groups decreased,and the decrease range was group C >group A >group B.The difference was not statistically significant.On the 7th day,the heart rate of the three groups increased,and the increase range was group C>group B>group A.The difference was not statistically significant.Comparison of 24-hour urine volume: The urine volume of the three groups increased after 48 hours of treatment,the increase rate of group A>group B>group C,the difference was statistically significant;the urine volume increased during 72 hours,the increase group A>group B>group C,the difference was statistically significant;the urine volume decreased when stopping the medicine after 24 hours,and the decrease was in group A < group B <group C,the difference was not statistically significant.Respiratory frequency comparison: The respiratory rate of the three groups decreased after 72 hours of treatment,the trend of decline group A>group B>group C,but no statistical significance;the respiratory rate increased when stopping the medicine after 24 hours,the increase trend group A<group B<group C,the difference was not statistically significant.Blood oxygen saturation comparison: the pulse oxygen levels of the three groups of patients increased in 72 hours,but the difference was not statistically significant;the pulse oxygen decreased in the three groups after 24 hours of medicine withdrawal,the difference was not statistically significant.NT-proBNP comparison: NT-proBNP decreased in group A and B in 24 hours,and decreased in group A.The difference was statistically significant in group C.The NT-proBNP decreased in 72 hours.The difference was statistically significant.NT-proBNP decreased in the three groups after 24 hours of medicine withdrawal,and the difference was statistically significant.Comparison of CKMB: Compared with group C,patients in group A and group B decreased at 14 hours after attack.Group A decreased more than group B,and group C increased significantly after check-in.The difference was statistically significant.CKMB of patients in groups A,B and C decreased at 24 hours,which are compared at 14 hours after attack,and the differences statistically significant.The CKMB of the three groups decreased at 72 hours after attack,and the difference was statistically significant.The CKMB value of the three groups fell back to normal levels on the 7th day after attack,and the difference was not statistically significant.Comparison of Cr: There was a slight increase in serum creatinine compared with admission after 24 hours of treatment in group A and B.There was no significant difference in serum creatinine in group C.There was no significant difference.There was a decrease in serum creatinine among three groups when medicines were used for 72 hours.There was no significant difference.There was no obvious change in serum creatinine among three groups when medicines were used on the seventh day,and the difference was not statistically significant.Conclusion:1.Early intravenous application of rh-BNP after PCI in acute anterior wall myocardial infarction can significantly increase the urine volume and oxygen saturation of patients,and significantly reduce the concentration of serum CKMB and NT-proBNP.2.In patients with acute anterior wall myocardial infarction undergoing PCI,intravenous application of rh-BNP in 6 hours of onset was significantly better than NIT in improving patients ' cardiac function.3.Early application of rh-BNP in patients with acute anterior wall myocardial infarction improved LVEF,LVEDV and LVESV trends.4.Rh-BNP overall safety and effectiveness of intravenous application in patients with acute anterior wall myocardial infarction. |
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