急性心肌梗死早期C反应蛋白水平对经皮冠状动脉介入治疗预后的影响

目的 探讨急性心肌梗死患者发病6 h内C反应蛋白水平对经皮冠状动脉介入治疗预后的预测意义.方法 测定84例急性心肌梗死患者发病6 h内血浆C反应蛋白水平,将患者分为C反应蛋白升高组(>5 mg/L)和C反应蛋白正常组(<5 mg/L).所有患者均予经皮冠状动脉介入治疗.比较两组一般临床资料、既往病史、冠状动脉病变情况等因素,随访记录心脏不良事件(再狭窄、同一部位再梗死、再发心绞痛、心功能衰竭和心源性猝死)的发生情况.结果 C反应蛋白升高组患者C反应蛋白水平和C反应蛋白峰值均高于C反应蛋白正常组,差异有统计学意义(P<0.05);C反应蛋白升高组患者发生冠状动脉病变支数多于C反应蛋白正常组,差异有统计学意义(P<0.05);C反应蛋白升高组患者随访期间心脏不良事件发生率为25.9%(7/27),明显高于C反应蛋白正常组(9.3%,5/54),差异有统计学意义(P<0.05).结论 急性心肌梗死发病6 h内C反应蛋白水平可作为预测经皮冠状动脉介入治疗预后的指标之一.

Influence of C Reactive Protein Level in Early Acute Myocardial Infarction on Prognosis After Percutaneous Coronary Intervention

Aim To investigate the significance of C reactive protein(CRP) in predicting the prognosis after percutaneous coronary intervention(PCI) within 6 hours after attack of acute myocardial infarction(AMI). Methods The CRP levels in plasma was detected in 84 AMI patients within 6 hours after attack,and the patients were divided into increased CRP group(CRP concentration >5 mg/L) and normal CRP group(CRP concentration <5 mg/L).All of the cases underwent PCI.The factors of common clinical data,past medical history,pathological changes of coronary artery were compared between the two groups,and the kak-incident occurrences of heart,for example restenosis,re-infarction in the same position,recurrent angina pectoris,heart failure and cardiogenic sudden death were observed by following-up. Results The CRP levels and the peak value in the increased CRP group were significantly higher than those in the normal CRP group,and there were significant difference between two groups(P<0.05). The quantities of coronary artery in the increased CRP group were more than those in the normal CRP group,and the incidence rate of kak-incident of heart in the increased CRP group was 25.9%(7/27),which was higher than 9.3%(5/54)in the normal CRP group(P<0.05). Conclusion The CRP levels within 6 hours after attack of AMI can be taken as one of the indexes to predict the prognosis of PCI.