血清脑钠肽、超敏C反应蛋白、肌酸激酶同工酶水平与经皮冠状动脉介入治疗术后患者预后的相关性  

Correlations between serum levels of brain natriuretic peptide,hypersensitive C-reactive protein as well as creatine kinase isoenzyme and prognosis of patients after percutaneous coronary intervention

作　　者：龚晓勇 胡晓蔚 何菲 胡剑平 GONG Xiaoyong;HU Xiaowei;HE Fei;HU Jianping(Department of Cardiovasology,Huangshan People′s Hospital of Anhui Province,Huangshan,Anhui,245000;Department of Cardiology,The Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230000)

机构地区：[1]安徽省黄山市人民医院心血管内科,安徽黄山245000 [2]安徽医科大学第二附属医院心内科,安徽合肥230000

出　　处：《实用临床医药杂志》2021年第11期72-76,共5页Journal of Clinical Medicine in Practice

基　　金：安徽省自然科学基金(1808085QH235);安徽省黄山市科技计划项目(2018Z-02)。

摘　　要：目的探讨急性心肌梗死患者经皮冠状动脉介入治疗(PCI)后血清脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)水平与近期预后的相关性。方法选取行PCI术的182例急性心肌梗死患者为研究对象,根据术后3个月内是否发生心血管不良事件将其分为预后不良组58例和预后良好组124例。采用酶联免疫吸附(ELISA)法检测患者血清BNP、hs-CRP、CK-MB水平;分析预后不良患者血清BNP、hs-CRP、CK-MB水平;分析血清BNP、hs-CRP、CK-MB水平对急性心肌梗死PCI后预后不良的预测价值;分析影响PCI患者术后预后不良的因素。结果预后不良组血清BNP、hs-CRP、CK-MB水平高于预后良好组,差异有统计学意义(P<0.05)。预后不良患者血清BNP与hs-CRP、CK-MB水平呈正相关(r=0.527,P<0.05;r=0.541,P<0.05),CK-MB与hs-CRP呈正相关(r=0.511,P<0.05)。血清BNP、hs-CRP、CK-MB及3者联合预测急性心肌梗死PCI后预后不良的曲线下面积(AUC)分别为0.872、0.763、0.921、0.949,特异性分别为87.9%、82.3%、94.4%、93.5%,敏感度分别为74.1%、63.8%、81.0%、87.9%。BNP、CK-MB是影响急性心肌梗死患者PCI后预后不良的独立危险因素(P<0.05)。结论血清BNP、hs-CRP、CK-MB对急性心肌梗死患者PCI后预后不良有一定的预测作用。Objective To investigate the correlations between serum brain natriuretic peptide(BNP),high-sensitivity C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB)and short-term prognosis in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 182 patients with acute myocardial infarction who underwent PCI were selected as the study subjects,and were divided into poor prognosis group(n=58)and good prognosis group(n=124)according to the occurrence of adverse cardiovascular events within three months after the operation.The serum levels of BNP,hs-CRP and CK-MB were detected by enzyme-linked immunosorbent assay(ELISA);the serum BNP,hs-CRP and CK-MB levels in patients with poor prognosis were analyzed;the predictive value of serum BNP,hs-CRP,CK-MB levels on the poor prognosis of acute myocardial infarction after PCI were analyzed;the factors affecting the poor prognosis of patients with PCI were analyzed.Results The serum levels of BNP,hs-CRP and CK-MB in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).Serum BNP was positively correlated with hs-CRP and CK-MB levels in patients with poor prognosis(r=0.527,P<0.05;r=0.541,P<0.05),there was a positive correlation between CK-MB and hs-CRP(r=0.511,P<0.05).The area under the curve(AUC)of serum BNP,hs-CRP,CK-MB alone and their combination in predicting poor prognosis after PCI were 0.872,0.763,0.921,0.949,respectively,the specificity were 87.9%,82.3%,94.4%,93.5%,respectively,and the sensitivity was 74.1%,63.8%,81.0%and 87.9%,respectively.NP and CK-MB were independent risk factors for poor prognosis in patients with acute myocardial infarction after PCI(P<0.05).Conclusion Serum BNP,hs-CRP and CK-MB have a certain predictive effect on the poor prognosis of patients with acute myocardial infarction after PCI.

关 键 词：急性心肌梗死 经皮冠状动脉介入 超敏C反应蛋白 脑钠肽 肌酸激酶同工酶 

分 类 号：R541.4[医药卫生—心血管疾病] R446.1[医药卫生—内科学]