急性STEMI患者PⅢNP、Hs-CRP与心室重构的关系

目的:观察急性ST段抬高心肌梗死(STEMI)患者Hs-CRP、血清Ⅲ型前胶原氨基端肽(PⅢNP)水平与心室重构和预后的关系。方法:100例STEMI患者入选,ELISA法测定入CCU即刻血清中Hs-CRP,PⅢNP和发病第7天血清中PⅢNP含量。于发病第(7±2)天和6个月时行超声心动图检查,6个月复查超声△LVEDVI增加≥20%为重构组,ALVEDVI增加<20%为非重构组。结果:STEMI患者第7天血清PⅢNP浓度明显高于入院水平(P<0.001)。第7天血清PⅢNP浓度与入院即刻Hs-CRP浓度之间呈正相关,r=0.364,P<0.001。6个月随访时左心室重构发生率为27.96%,Logistic回归分析,Hs-CRP和第7天血清PⅢNP浓度为左心室重构发生的独立相关因素。结论:STEMI患者入院Hs-CRP和第7天血清PⅢNP水平与半年时心室重构的发生密切相关。

Relation Among Ventricular Remodeling、Hs-CRP and PⅢNP in Patients with STEMI

Objective:The aim of this study was to analyse the relation among ventricular remodeling,Hs-CRP and PⅢNP in patients with STEMI.Methods:100 patients with acute STEMI were evaluated.ELISA was used to determine admission Hs-CRP,PⅢNP and the seventh day PⅢNP concentration.On the 7^thday and the 6^thmonth two-dimensional echocardiograms were measured using GE Vivid Five.LVEF and LVEDV were evaluated by the area-length method from the four-chamber view.Results:On the 7^thday the PⅢNP level of STEMI patients were significantly higher than admission（P<0.001）.The PⅢNP concentration on the 7^thday had markedly positive correlation with admission concentration of Hs-CRP （R=0.364,P<0.001）.6 months follow-up revealed that 26 of 93 STEMI（27.96%）patients suffered by left ventricular remodeling.By Logistic analysis,Hs-CRP and the seventh day level of PⅢNP were significant independent predictors of left ventricular remodeling（P<0.001）.Conclusion: The admission Hs-CRP and the 7^thday PⅢNP concentration is associated with 6 months left ventricular remodeling in patients of STEMI.