高敏C反应蛋白、B型钠尿肽与急性心肌梗死患者心功能关系的临床研究

目的 分析探讨急性心肌梗死(AMI)患者血浆超敏C反应蛋白(hs-CRP)与B型钠尿肽(BNP)的变化及其临床意义.方法 选择60例AMI患者为观察组,并选择同期非急性心肌梗死患者60例作为对照组,采用免疫散射比浊法检测hs-CRP水平,同时以彩色多普勒检测并计算左室射血分数(LVEF)、左室后壁收缩期增厚率(△T％),并测定BNP水平.结果 AMI Ⅰ组、Ⅱ组、Ⅲ组和Ⅳ组中血清hs-CRP和BNP水平明显高于对照组,并随心功能Killip分级的增加而升高,血清hs-CRP与BNP水平和心功能Killip分级呈正相关(P＜0.05).AMI患者hs-CRP和BNP水平与左心室射血分数(LVEF)呈负相关(P＜0.05),与左心室舒张末期内经(LVEDD)呈正相关(P＜0.05).结论 血浆hs-CRP和BNP水平与AMI预后显著相关,均是独立的不良的预测因子,可以作为评价梗死后心功能状态和近期预后的敏感指标,亦可用于AMI的危险分层及判断预后.

Clinical studies of high-sensitivity C-reactive protein and B-type natriuretic peptide in patients with acute myocardial infarction

OBJECTIVE To investigate high sensitivity C-reactive protein(hs-CRP) and B-type natriuretic peptide(BNP) in patients with acute myocardial infarction(AMI).METHODS 60 patients with AMI were in the observation group and 60 subjects without acute myocardial infarction were in the control group.The hs-CRP levels were detected by immuno-scatter turbidmetry,and left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness of systole(△ T),and BNP levels were assayed by Color Doppler.RESULTS The serum hs-CRP and BNP levels of AMI Group Ⅰ,group Ⅱ,group Ⅲ and Ⅳ group were significantly higher,and they increased with the development of Killip classifications(P﹤0.05).The hsCRP and BNP levels of AMI patients were negatively correlated with left ventricular ejection fraction(LVEF)(P﹤0.05),and positively correlated with left ventricular diastolic diameter(LVEDD)(P﹤0.05).CONCLUSION The hs-CRP and BNP levels are independent predictors of AMI,which can be used in classification and prognosis of AMI.