心脏内畸形合并感染性心瓣膜炎的外科治疗

目的初步探讨ST段抬高心肌梗死（STEMI）患者植入雷帕霉索药物洗脱支架（Cypher支架）和裸支架后，血清高敏C-反应蛋白（ha—CRP）水平的变化以及对判断预后的意义。方法226枚Cypher支架（Cypher支架组）和102枚裸支架（裸支架组）在急诊经皮冠状动脉介入（PCI）治疗时植入梗死相关动脉。在术前、术后8h和术后24h取静脉血测量血清hs—CRP。结果Cypher支架组和裸支架组患者术前和术后血清hs—CRP各时间点差异无统计学意义（P〉0．05）。术后随访12个月，有主要心血管事件患者与无主要心血管事件患者相比，血清hs—CRP术前差异无统计学意义（P〉0．05），但术后8h和术后24h差异有统计学意义（P（0．05），其中在有无主要心血管事件上，Cypher支架组内在各时间点血清hs—CRP差异无统计学意义（p〉0．05），裸支架组内在术后8h和术后24h血清hs—CRP差异有统计学意义（P〈0．05）。结论急诊PCI治疗植入裸支架的STEMI患者。术后8h和术后24h血清hs—CRP升高，12个月后主要心血管事件增多；急诊PCI治疗植入Cypher支架的STEMI患者，12个月后主要心血管事件与血清hs—CRP升高无明显关系。

The prognostic value of high sensitivity C-reactive protein after implantation of sirolimus drug-eluting stents and bare stents in acute myocardial infarction patients

Objective To investigate the prognostic value of high sensitivity C-reactive protein (hs-CRP) after implantation of sirolimus drug-eluting stents(Cypher stents) and bare stents in acute myocardial infarction patients. Methods Two hundred and twenty-six Cypher stents (Cypher stents group)and 102 bare stents (bare stents group)were implanted in infarction-related arteries during emergency percutaneous coronary intervention (PCI)therapy.The blood samples were obtained just before operation and after operation at 8-hour and 24-hour to detect the level of hs-CRP. Results There was no difference of hs-CRP levels between Cypher stents group and bare stents group at different time(P >0.05).At 12-month follow-up after operation,although there were no difference of baseline hs-CRP level (P>0.05), hs-CRP levels after PCI operation at 8-hour and 24-hour were statistically different between main accidents of cardiac events (MACE) group and non-MACE group(P <0.05).The bare stents group also had the same result,but the Cypher stents group didn't have. Conclusions The elevation of hs-CRP level at 8-hour and 24-hour after emergency PCI therapy operation is associated with one-year MACE in bare stents group,but not in Cypher stents group.