中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2009年
13期
10-12
,共3页
心肌梗死%利钠肽%脑%C反应蛋白质
心肌梗死%利鈉肽%腦%C反應蛋白質
심기경사%리납태%뇌%C반응단백질
Myocardial infarction%Natriuretic peptide,brain%C-reactive protein
目的 观察ST段抬高心肌梗死(STEMI)患者血浆高敏c反应蛋白(hs-CRP)和脑利钠肽(BNP)水平的变化,分析其与预后的关系.方法 首发急性STEMI患者80例,其中行原发经皮冠状动脉介入治疗(PCI)25例(原发PCI组),行延迟PCI 27例(延迟PCI组),采用保守药物治疗28例(药物治疗组).测定各组患者发病不同时段hs-CRP、BNP及肌酸激酶同工酶-MB(CK-MB)峰值水平,行超声心动图检查,并进行比较.结果 hs-ClIP水平随时间呈动态变化,在原发PCI组达峰值时间前移.原发PCI组hs-CRP峰值、CK-MB峰值、BNP、室壁运动分数指数(WMSI)、左室重构(LVR)发生率与延迟PCI组和药物治疗组比较均下降,左室射血分数(LVEF)水平升高,差异均有统计学意义(P<0.05);延迟PCI组与药物治疗组上述指标比较,差异无统计学意义.多元回归分析结果显示,LVEF与hs-CRP、BNP及WMSI呈负相关,r值分别为-0.895、-0.940和-0.939,P<0.01;hs-CRP与BNT、CK-MB呈正相关,r值分别为0.935和0.886,P<0.01.结论 监测hs-CRP水平可提示早期再灌注治疗的成功与否及非再灌注治疗患者梗死相关病变的稳定性,与BNP联合检测可更好地预测STEMI患者的早期预后.
目的 觀察ST段抬高心肌梗死(STEMI)患者血漿高敏c反應蛋白(hs-CRP)和腦利鈉肽(BNP)水平的變化,分析其與預後的關繫.方法 首髮急性STEMI患者80例,其中行原髮經皮冠狀動脈介入治療(PCI)25例(原髮PCI組),行延遲PCI 27例(延遲PCI組),採用保守藥物治療28例(藥物治療組).測定各組患者髮病不同時段hs-CRP、BNP及肌痠激酶同工酶-MB(CK-MB)峰值水平,行超聲心動圖檢查,併進行比較.結果 hs-ClIP水平隨時間呈動態變化,在原髮PCI組達峰值時間前移.原髮PCI組hs-CRP峰值、CK-MB峰值、BNP、室壁運動分數指數(WMSI)、左室重構(LVR)髮生率與延遲PCI組和藥物治療組比較均下降,左室射血分數(LVEF)水平升高,差異均有統計學意義(P<0.05);延遲PCI組與藥物治療組上述指標比較,差異無統計學意義.多元迴歸分析結果顯示,LVEF與hs-CRP、BNP及WMSI呈負相關,r值分彆為-0.895、-0.940和-0.939,P<0.01;hs-CRP與BNT、CK-MB呈正相關,r值分彆為0.935和0.886,P<0.01.結論 鑑測hs-CRP水平可提示早期再灌註治療的成功與否及非再灌註治療患者梗死相關病變的穩定性,與BNP聯閤檢測可更好地預測STEMI患者的早期預後.
목적 관찰ST단태고심기경사(STEMI)환자혈장고민c반응단백(hs-CRP)화뇌리납태(BNP)수평적변화,분석기여예후적관계.방법 수발급성STEMI환자80례,기중행원발경피관상동맥개입치료(PCI)25례(원발PCI조),행연지PCI 27례(연지PCI조),채용보수약물치료28례(약물치료조).측정각조환자발병불동시단hs-CRP、BNP급기산격매동공매-MB(CK-MB)봉치수평,행초성심동도검사,병진행비교.결과 hs-ClIP수평수시간정동태변화,재원발PCI조체봉치시간전이.원발PCI조hs-CRP봉치、CK-MB봉치、BNP、실벽운동분수지수(WMSI)、좌실중구(LVR)발생솔여연지PCI조화약물치료조비교균하강,좌실사혈분수(LVEF)수평승고,차이균유통계학의의(P<0.05);연지PCI조여약물치료조상술지표비교,차이무통계학의의.다원회귀분석결과현시,LVEF여hs-CRP、BNP급WMSI정부상관,r치분별위-0.895、-0.940화-0.939,P<0.01;hs-CRP여BNT、CK-MB정정상관,r치분별위0.935화0.886,P<0.01.결론 감측hs-CRP수평가제시조기재관주치료적성공여부급비재관주치료환자경사상관병변적은정성,여BNP연합검측가경호지예측STEMI환자적조기예후.
Objective To observe the levels of plasma high sensitive C-reactive protein (hs-CRP) and brain natriuretic peptide (BNP) in patients with ST-segment elevation myocardial infarction ( STEMI)and analyze their significance. Methods This study enrolled 80 patients who had first acute STEMI. Twenty-five patients were in the primary percutaneons coronary intervention (PCI) group, 27 patients were in the delayed PCI group and 28 patients were in the medical treatment group. The levels of hs-CRP, BNP and creatine kinase MB (CK-MB) were measured after treatment. Left ventricular function and ventricular wall thinning ratio were evaluated by echocardiography. Results The levels of plasma hs-CRP showed dynamic variation with time in all patients. The peak time of hs-CRP was significantly different among the three groups. The peak value of hs-CRP, BNP, wall motion score index ( WMSI ) and the incidence of left ventricular remodeling decreased, but the level of loft ventricular ejection fraction (LVEF) increased in the primary PCI group. Compared with the delayed PCI group and the medical lreatment group, there were significant difference. Correlational analysis showed that there were negative relationship between LVEF and hs-CRP, BNP,WMSI (r = -0.895, -0.940, -0.939,P < 0.01 ) and positive relationship between hs-CRP and BNP, CK-MB (r = 0.935,0.886, P < 0.01 ). Conclusions The associated measure of hs-CRP and BNP could preferably evaluate the inchoate prognosis of STEMI. hs-CRP might be an useful index of successful reperfusion and predict the stability of infarction related lesion.
