急性心肌梗死患者血清hsCRP水平与急诊冠脉介入治疗后心衰的关系  

Relationship between serum level of hsCRP and heart failure after primary PCI in AMI patients

作　　者：史卫国[1] 牟晓雯[2] 袁涛[1] 王津文 周春[2] 

机构地区：[1]青岛市第八人民医院心内科,山东青岛266100 [2]青岛市第八人民医院特检科,山东青岛266100

出　　处：《心血管康复医学杂志》2012年第2期158-161,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨急性心肌梗死(AMI)患者接受急诊冠状动脉介入治疗(PCI)术后心力衰竭与术前高敏C反应蛋白(hsCRP)水平之间的关系。方法:对于170例首次AMI患者根据入院hsCRP的水平分为G1组(hsCRP≤5.1mg/L,44例),G2组(5.2mg/L<hsCRP≤16.5mg/L,50例),G3组(16.5mg/L<hsCRP≤38.6mg/L,39例),G4组(hsCRP>38.6mg/L,37例),比较各组心力衰竭发生率。采用Logistic逐步回归法分析急诊PCI术后心力衰竭发生的危险因素。结果:两年中34例(20%)发生心力衰竭。随着PCI术前hsCRP水平的升高,心力衰竭的发生率逐渐上升(G1组～G4组分别为:9.1%比16.0%比28.2%比29.7%,P均<0.05);与同组PCI术后1周比较,术后1年时G3组、G4组的左室舒张末期容积指数[(58.61±10.10)ml/m2比(61.84±9.92)ml/m2,(59.70±11.88)ml/m2比(66.46±10.52)ml/m2]、左室收缩末期容积指数[(28.20±6.55)ml/m2比(31.06±7.14)ml/m2,(27.40±6.49)ml/m2比(31.62±8.03)ml/m2]明显增加,左室射血分数明显减低[(52.56±7.58)%比(49.56±9.63)%,(53.19±8.12)%比(48.73±7.11)%],P<0.05～0.01。Logistic逐步回归分析显示术前hsCRP水平是AMI患者发生心衰的预测因素(相对危险度为1.052,P=0.003)。结论:高敏C反应蛋白是急性心肌梗死患者PCI术后心力衰竭发生的预测因子之一。Objective： To investigate relationship between preoperative serum level of high sensitive C reactive protein（hsCRP） and chronic heart failure（CHF）after primary percutaneous coronary intervention（PCI） in patients with acute myocardial infarction（AMI）.Methods：According to hsCRP level at admission,a total of 170 patients with first AMI onset were divided into group G1（hsCRP≤5.1 mg/L,n=44）,group G2（5.2 mg/LhsCRP≤16.5 mg/L,n=50）,group G3（16.5 mg/LhsCRP≤38.6 mg/L,n=39） and group G4（hsCRP38.6 mg/L,n=37）.CHF incidence rate of each group was compared.Logistic gradual regression method was used to analyze risk factors for heart failure after primary PCI.Results：A total of 34（20%） cases occurred CHF within two years.As preoperative hsCRP level increased,CHF incidence rate gradually increased（from group G1 to G4 was 9.1% vs.16.0% vs.28.2% vs.29.7% respectively,P0.05 all）;Compared with one week after PCI,there were significant increase in left ventricular end-diastolic volume index [（58.61±10.10） ml/m2 vs.（61.84±9.92） ml/m2,（59.70±11.88） ml/m2 vs.（66.46±10.52） ml/m2]and left ventricular end-systolic volume index [（28.20±6.55） ml/m2 vs.（31.06±7.14） ml/m2,（27.40±6.49） ml/m2 vs.（31.62±8.03） ml/m2],and significant decrease in LVEF [（52.56±7.58）% vs.（49.56±9.63）%;（53.19±8.12）% vs.（48.73±7.11）%]after PCI one year in group G3 and group G4,P0.05~0.01.Logistic gradual regression indecated that preoperative hsCRP level was a predictive factor for CHF in AMI patients（relative risk=1.052,P=0.003）.Conclusion： hsCRP is one of predictive factors for CHF after PCI in AMI patients.

关 键 词：C反应蛋白质 血管成形术 经腔 经皮冠状动脉 心肌梗塞 

分 类 号：R587.1[医药卫生—内分泌]