The Clinical Effect Of PBMV And Dynamic Changes And Significance Of BNP, Hs-CRP And ET-1

Objective:Discuss about the clinical effect on the patients of rheumatic mitral stenosis after PBMV treating and about the dynamic changes and significance of PBMV patients on BNP, hs-CRP and ET-1.Methods:The author chose 39 PBMV inpatients caused by rheumatic mitral stenosis in our section, including 14 male patients and 25 female patients, with the average age 48 ± 11.6. Color Doppler ultrasound was used to measure MVA, LAD, etc., as well as LAP and PAP. And the author observed the above mentioned indexes before the operation and on the 10th day, the 30th day and the 60th day after operation. At the same time, the author extracted peripheral venous blood to measure BNP, Hs-CRP and ET-1 concentration.Results:1. Among the 39 PBMV patients,36 were successful. The success rate is 92.3%.2. About the 36 successful PBMV patients, the color Doppler ultrasound demonstrated that MVA was obviously enlarged after operation, and 10 days, 30 days and 60 days after the operation, MVA had no significant difference (P>0.05). Right after PBMV, LAD had no remarkable change compared with pre-operation,10 days,30 days and 60 days later, LAD shinked gradually with significant difference compared with pre-PBMV. PAP and LAP had dramatic decline right after PBMV.3. BNP concentration in patients’plasma gradually declined after PBMV with significant difference compared with pre-PBMV (P<0.01). hs-CRP concentration had no significant difference before and 10 days after operation(P>0.05); but 10 days,30 days and 60 days after PBMV, hs-CRP concentration declined gradually, and significant difference appeared(P< 0.01); ET-1 concentration had no significant difference before and 10 days after operation (P>0.05); but 10 days,30 days and 60 days after PBMV, ET-1 concentration in plasma declined gradually and significant difference arised(P<0.01).4. The 36 successful PBMV patients had quick improvement on clinical symptoms after operation, and their survival quality also improved obviously.5. There 3 failed cases, which were resulted from complication, including 1 cardiac perforation, 1 acute left heart failure cause by valve injury and 1 operation termination caused by acute cerebral infarction during operation. Conclusions:1. PBMV operation has less trauma, faster postoperative recovery; and it is easily accepted by patients.2. PBMV can enlarge MVA effectively, reduce pulmonary artery pressure, shrink left atrial diameter, improve patients’ clinical symptoms quickly and improve their survival quality.3. The biological marker after PBMV, including BNP, hs-CRP and ET-1 etc. declined. This may relate to the enlargement of MVA and the pressure drop of left atrium which may improve hemodynamics.