高敏C反应蛋白浓度与冠心病院内不良事件发生的关系  

The change and signficance of high-sensitivity C-reactive protein level in different therapies for patients with acute myocardial infarction

作　　者：夏福纯[1] 李广镰[1] 罗义[1] 曾冲[1] 潘宜智[1] 冯开薇[1] 皮耀球[1] 刘震[1] 雷晓明[1] 

机构地区：[1]广州医学院附属广州市第一人民医院心内科,广州市510180

出　　处：《岭南心血管病杂志》2004年第6期426-429,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的　比较高敏C反应蛋白 (hs CRP)在急性心肌梗死 (AMI)介入 (PCI)治疗和药物保守治疗中的变化及其与院内主要不良事件 (MSCE)的关系。方法　 5 2例AMI患者 ,按病人治疗方式不同分为PCI组和药物组。检测所有患者入院后 8个时点的血浆hs CRP浓度 ,比较住院期间两组病人hs CRP变化及其与院内MACE的关系。结果　院内MACE发生率在药物组显著高于PCI组 (P <0 0 1)。两组病人hs CRP入院即刻浓度和峰浓度无显著性差异 (P >0 0 5 ) ;院内MACE与入院即刻hs CRP浓度 ,在药物组呈显著相关(r=0 72 8,P =0 0 2 6 ) ,而在PCI组无明显相关 (r =0 2 94 ,P =0 0 91) ;药物组入院即刻hs CRP浓度 >3mg/L的患者MACE发生率显著高于hs CRP <3mg/L的患者 (P <0 0 5 ) ,而PCI组则无显著性差异 (P >0 0 5 ) ;hs CRP峰浓度与院内MACE的发生在两组均无明显相关 (P >0 0 5 ) ,两组MACE发生率在hs CRP峰浓度 <12mg/L的患者 >12mg/L的患者均无显著差异 (P >0 0 5 )。结论　AMI介入治疗比药物治疗可以显著减少院内MACE的发生 ;入院即刻hs CRP浓度与院内MACE有明显的正相关 ,>3mg/L的患者应尽量选择PCI治疗以减少院内MACE的发生 ;hs CRP峰浓度与院内MACE的发生无明显相关 ,不宜作为指导防范院内MACE发生的指标。Objectives To observe the change of high-sensitivity C-reactive protein (hs-CRP) level during therapy with percutaneous coronary intervention (PCI) or medicines in patients with acute myocardial infarction (AMI), and to compare the relation between hs-CRP and the main adverse cardiovascular events (MACE) in-hospital. Methods The 52 patients with AMI were divided into PCI group or medical group. Venous blood samples were taken to examine plasma hs-CRP level at instanter 6 hs, 12 hs, 18 hs, 24 hs, 48 hs, 72 hs, 7 days after admission, To observe the change of hs-CRP and compare the relation between hs-CRP and the MACE in-hospital. Results The MACE incidence rate of medical group was significantly higher than that of PCI group (P<0.01). There were no significantly differences between the instant and peak hs-CRP density (P>0.05) between two groups, in-hospital instant hs-CRP hs-CRP level correlated significantly to the MACE of medical group (r=0.728,P=0.026), but in PCI group, the relativity is not significance. (r=0.294, P=0.091). In the medical group, the MACE occurrence rate of the patient of the instant hs-CRP level >3 mg/L shows significantly higher than that of the hs-CRP instant level <3 mg/L (P<0.05), but in the PCI group, which has no significant difference (P>0.05). The peak density of hs-CRP has no related significantly to the MACE in-hospital between two groups (P>0.05); on the basis of the hs-CRP peak level <12 mg/L and >12 mg/L divide two pieces to compre, the incidence rate of MACE has no significant difference between two groups (P>0.05). Conclusions The MACE rate of PCI treatment is significantly lower than that of medicine therapy in patients with AMI. The in-hospital instant hs-CRP density is significantly related to the incidence of MACE, patients of the instant hs-CRP densith >3 mg/L should best choose PCI to reduce the incidence of MACE in-hospital. The hs-CRP peak density isn't significantly related to the incidence of MACE, it shouldn't to be a marker that coach to keep away the MACE in-ho

关 键 词：高敏C反应蛋白 冠心病 心血管事件 急性心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]