CAJ | 학술논문

目的观察急性心肌梗死（AMI）患者急诊 PCI 术前后高敏 C 反应蛋白( hs- CRP)和血浆氮末端脑钠肽前体（NT-proBNP）水平变化，探讨hs-CRP和NT-p roBNP水平对急诊PCI术后左室重塑及近期预后的价值。方法选择156例AMI患者，80例于胸痛发作12h内行PCI成功者为急诊PCI组，76例未进行PCI者为对照组。测定入院即刻、24h、72h、7d和1个月、3个月的hs-CRP和NT-proBNP水平变化。同时于患者入院时、术后1个月行超声心动图检查，测定左室舒张末期容积指数（LVEDVI）和左室收缩末期容积指数（LVESVI）及左室射血分数（LVEF），并随访3～6个月，观察主要不良心血管事件（MACE)的发生情况。结果药物治疗组的近期血清NT-proBNP水平显著高于PCI组；药物治疗组的72 h～7d的血清hs-CRP水平显著高于PCI组；近期PCI组的MACE事件低于药物治疗组。结论急诊PCI组3～6个月内治疗效果优于药物治疗组。血清NT-proBNP能够对AMI患者进行危险分层，预测MACE的发生率；hs-CRP可作为行急诊PCI的AMI患者的近期预后的预测因子。
목적관찰급성심기경사（AMI）환자급진 PCI 술전후고민 C 반응단백( hs- CRP)화혈장담말단뇌납태전체（NT-proBNP）수평변화，탐토hs-CRP화NT-p roBNP수평대급진PCI술후좌실중소급근기예후적개치。방법선택156례AMI환자，80례우흉통발작12h내행PCI성공자위급진PCI조，76례미진행PCI자위대조조。측정입원즉각、24h、72h、7d화1개월、3개월적hs-CRP화NT-proBNP수평변화。동시우환자입원시、술후1개월행초성심동도검사，측정좌실서장말기용적지수（LVEDVI）화좌실수축말기용적지수（LVESVI）급좌실사혈분수（LVEF），병수방3～6개월，관찰주요불양심혈관사건（MACE)적발생정황。결과약물치료조적근기혈청NT-proBNP수평현저고우PCI조；약물치료조적72 h～7d적혈청hs-CRP수평현저고우PCI조；근기PCI조적MACE사건저우약물치료조。결론급진PCI조3～6개월내치료효과우우약물치료조。혈청NT-proBNP능구대AMI환자진행위험분층，예측MACE적발생솔；hs-CRP가작위행급진PCI적AMI환자적근기예후적예측인자。
Objective To investigate the clinical significance and predictive value of high- sensitivity C- reactive protein ( hs-CRP) and N-terminal pro-brain natriuretic peptide in patients with acute myocardial infarction after primary percutaneous coronary intervention (PCI). Methods A total of 80 AMI patients successfully underwent primary PCI and in whom plasma hs-CRP and NT-proBNP were measured,respectively, 24 h,72 h,7 days,30 days and 3 months after PCI.Major adverse cardiac events ( MACE) were observed during hospitalization and within 3-6 months after PCI.Plasma hs-CRP and NT-proBNP levels as well as incidence of MACE in 76 AMI in medically treated group and 30 healthy controls were also examined during the same period and compared with those in PCI group. Results Short-term plasma NT-proBNP levels in medically treated group were significantly higher than those in PCI group,but plasma hs-CRP levels within 72 h-7 days were significantly higher in PCI group compared with those in medicine treatment group.MACE in PCI group was lower than that in medically treated group. Conclusion Both plasma hs-CRP and NT- proBNP are good predictors for mortality and MACE incidence in AMI patients treated with PCI or medications.hs-CRP is a short-term prognostic factor for AMI patients treated with primary PCI,whereas NT-proBNP is a long-term prognostic factor for AMI patients.