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目的：探讨急性心肌梗死患者血浆脑钠肽（BNP）水平与梗死相关动脉及病变血管的关系。方法：选取2010.7-2011.7 于上海市第一人民医院诊断为急性心肌梗死的患者。分为ST 抬高型心梗患者和非ST 抬高型心梗患者两组，比较BNP 水平与血管病变的关系。结果：（1）两组患者的年龄、男女比例、高血压病与糖尿病患病率、吸烟患者比例之间无显著差异。NSTEMI 患者中，既往心梗和既往经皮冠状动脉成形术（PTCA）的比例和左室射血分数明显高于STEMI 患者。（2）NSTEMI 患者多支血管病变比例显著高于STEMI 患者并且梗死相关动脉为左回旋支（LCX）的比例显著高于STEMI 患者。（3）病变血管支数与心梗患者BNP 水平无关，STEMI 患者左冠状动脉前降支（LAD）为IRA 的患者BNP 水平显著高于LCX 和右冠状动脉（RCA）分别为IRA 的患者。NST EMI 患者LAD、LCX 和RCA 分别为IRA 的患者其BNP 水平无显著差异。结论：STEMI 患者前壁心梗BNP 水平较高，NSTEMI 患者BNP 水平对血管病变支数和IRA 无预测价值。

英文摘要:

Objective: We hypothesized that elevated B-type natriuretic peptide (BNP) levels would be associated with a greater severity of angiographic disease and a greater extent of myocardium at risk in patients with acute myocardial infarction (AMI). Methods: In this retrospective study, consecutive 149 patients with STEMI and 63 with NSTEMI were included. These patients were separated into STEMI group and NSTEMI group. Results: The proportion of previous MI (12.7%) and PTCA (15.9%) and left ventricular ejection fraction in NSTEMI group was higher than STEMI group. Circumflex artery as the culprit vessel was more often in NSTEMI group (38.1%) than in STEMI group (12.1%, P<0.0001). There was no correlation between BNP level and the number of narrowed coronary artery in patients with AMI. In STEMI group, BNP level was higher when LAD as culprit vessel than circumflex artery or right coronary artery. In NSTEMI group, there was no correlation between BNP levels and culprit lesion location. Conclusions: BNP levels were higher in patients with STEMI with anterior wall location. BNP had no predictive value on culprit lesion location in patients with NSTEMI.

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