C反应蛋白水平与急性心肌梗死溶栓患者预后的临床研究

目的　观察血清C反应蛋白 (CRP)水平变化与急性心肌梗死 (AMI)溶栓治疗后再通以及 4周内患者预后的相互关系。方法　根据溶栓后血管再通情况 ,将 43例患者分为血管再通组 (32例 )和血管未通组 (11例 ) ,将溶栓后 1周内不同时间血清CRP水平变化与梗死血管再通关系、梗死后 4周内心脏事件发生率即梗死后心绞痛、再梗死、严重心律失常的发生率以及心功能状态进行对比分析。结果　 (1)血清CRP水平升高后持续下降者显示较持续升高者梗死血管再通率所占比例明显升高 ,分别为 71.9%和 3.1%(P <0 .0 1) ;(2 )前者 4周内梗死后心脏事件发生率较后者明显减少 ,其中梗死后心绞痛发生率分别为 8.3%和 6 2 .5 %(P <0 .0 1)。结论　AMI溶栓后血清CRP水平的变化在预测溶栓后再通和患者预后中具有一定的临床价值。

Clinical study of C-reactive protein level and prognosis of the patients with acute myocardial infarction after thrombolysis

Objective To investigate the relations of the level of C-reactive protein (CRP) to the reperfusion and prognosis of the patients with acute myocardial infarction(AMI) within 4 weeks after thrombolytic therapy.Methods According to the reperfusion after thrombolysis,43 patients were divided into two groups (the reperfusion group,n=32,and the non-reperfusion group,n=11).Correlation analysis between CRP at different time points within 1 week after thrombolysis and the reperfusion,the incidence of cardiac events,such as the post-infarction angina pectoris,reinfarction,severe arrhythemia and heart function,within 4 weeks was carried out.Results (1)The reperfusion rates in patients exhibiting continuous decrease in CRP and continuous increase in CRP were 71.9% and 3.1% respectively(P<0.01).(2)The incidence of cardiac events was lower in patients with low CRP than in patients with high CRP within 4 weeks.Among the cardiac events,the incidence of post-infarction angina pectoris in the former and the latter was 8.3%vs.62.5%,P<0.01.Conclusion CRP plays a role in the reperfusion and has certain value for predicting the prognosis of the patients with AMI after thrombolytic therapy.