入院C反应蛋白水平对ST段抬高型心肌梗死合并糖尿病患者冠状动脉无复流的影响  

Effect of admission C-reactive protein level on coronary no-reflow in patients with ST-segment elevation myocardial infarction complicated with diabetes mellitus

作　　者：师树田[1] 甄雷[1] 郝问 聂绍平[1] SHI Shu-tian;ZHEN Lei;HAO Wen;NIE Shao-ping(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科,北京市100029

出　　处：《中国心血管病研究》2022年第7期597-601,共5页Chinese Journal of Cardiovascular Research

基　　金：国家高技术研究发展计划(863计划)(2015AA020102);北京市医院管理局临床医学重点发展专项(ZYLX201710);北京市医院管理局科研培育计划(PX2019021)。

摘　　要：目的探讨入院C反应蛋白(CRP)水平对急性ST段抬高型心肌梗死(STEMI)合并糖尿病患者直接经皮冠状动脉介入治疗(pPCI)术中无复流的影响。方法连续纳入2017年1月至2018年8月就诊于我院急诊,诊断为STEMI合并糖尿病患者,按照入院高敏C反应蛋白(hsCRP)水平分为两组,CRP增高组(hsCRP>3 mg/L,n=112),CRP正常组(hsCRP≤3 mg/L,n=71)。分析入选患者基线资料、梗死相关动脉基本情况以及介入操作特点。主要终点:介入治疗术中无复流现象。次要终点:住院期间全因死亡和心血管死亡。结果两组患者基线资料没有明显差别,具有可比性。两组之间梗死相关动脉位置及介入操作特点均无明显差异。CRP增高组发生无复流43例(38.4%),CRP正常组术发生无复流16例(22.5%),CRP增高组无复流发生比例明显高于CRP正常组(P=0.025)。CRP增高组与CRP正常组相比较,院内全因死亡及心血管死亡均无明显统计学差异。结论对于STEMI合并糖尿病患者,入院CRP水平增高与pPCI术中冠状动脉无复流的发生率增加相关,与住院期间全因死亡及心血管死亡风险无关。Objective To investigate the effect of the admission C-reactive protein(CRP)level on no reflow during primary percutaneous coronary intervention(pPCI)in the patients with acute ST-segment elevation myocardial infarction(STEMI)complicated with type 2 diabetes.Methods The patients who were admitted to the emergency department of our hospital from January 2017 to August 2018 and diagnosed with STEMI complicated with diabetes were divided into two groups according to the level of admission high-sensitivity C reactive protein(hsCRP),the increased CRP group(hsCRP>3 mg/L,n=112)and the normal CRP group(hsCRP≤3 mg/L,n=71).The baseline data,basic conditions of infarct-related arteries and the characteristics of interventional procedures were analyzed.Primary endpoint:the rate of no-reflow during interventional therapy.Secondary endpoints:all cause and cardiovascular death in hospital.Results There was no significant difference in the baseline data between the two groups of patients.There were no significant differences in the location of the infarct-related arteries and the characteristics of the interventional procedures between the two groups.No-reflow occurred in 43 cases(38.4%)in the increased CRP group and in 16 cases(22.5%)in the normal CRP group.The incidence rate of no-reflow in the increased CRP group was significantly higher than that in the normal CRP group(P=0.025).There was no significant difference in in-hospital all-cause death and cardiovascular death between the two groups.Conclusion In patients with STEMI and type 2 diabetes,the increased CRP level on admission is associated with an increased incidence of the coronary no-reflow during pPCI,but not associated with the risk of in-hospital all-cause and cardiovascular death.

关 键 词：急性ST段抬高型心肌梗死 C反应蛋白 2型糖尿病 无复流 

分 类 号：R542.22[医药卫生—心血管疾病]