CAJ | 학술논문

目的：探讨急性心肌梗死（AMI）患者接受抗凝和溶栓治疗前后，超敏C反应蛋白（hs‐CRP）、纤维蛋白原（Fib）、D‐二聚体（D‐D）检测的临床价值。方法选取于该院心内科住院的110例AMI患者，分别在治疗前后测定其血浆hs‐CRP、Fib、D‐D及心肌损伤标志物水平。结果110例AMI患者中66例患者治疗前及治疗至24 h血浆中hs‐CRP、Fib、D‐D水平均升高（高于阈值）；44例患者治疗前及治疗至24 h血浆中的hs‐CRP和Fib水平升高，而D‐D不升高。结论 hs‐CRP的检测对AM I的诊断、治疗有一定价值，是判断心肌损伤又一较好标志物，治疗24～48 h与治疗12 h内的患者血浆hs‐CRP水平相比能更好地反映AMI患者心肌损伤的严重程度和预后；Fib经治疗后其水平降低缓慢，不能用于 AMI患者的疗效观察；D‐D的水平对诊断 AMI无确定阴性预测值，不能成为AMI的筛选排除指标，但D‐D阳性AMI患者的D‐D水平可作为疗效监测指标。
목적：탐토급성심기경사（AMI）환자접수항응화용전치료전후，초민C반응단백（hs‐CRP）、섬유단백원（Fib）、D‐이취체（D‐D）검측적림상개치。방법선취우해원심내과주원적110례AMI환자，분별재치료전후측정기혈장hs‐CRP、Fib、D‐D급심기손상표지물수평。결과110례AMI환자중66례환자치료전급치료지24 h혈장중hs‐CRP、Fib、D‐D수평균승고（고우역치）；44례환자치료전급치료지24 h혈장중적hs‐CRP화Fib수평승고，이D‐D불승고。결론 hs‐CRP적검측대AM I적진단、치료유일정개치，시판단심기손상우일교호표지물，치료24～48 h여치료12 h내적환자혈장hs‐CRP수평상비능경호지반영AMI환자심기손상적엄중정도화예후；Fib경치료후기수평강저완만，불능용우 AMI환자적료효관찰；D‐D적수평대진단 AMI무학정음성예측치，불능성위AMI적사선배제지표，단D‐D양성AMI환자적D‐D수평가작위료효감측지표。
Objective To discuss the clinical value of high sensitivity C‐reactive protein(hs‐CRP) ,fibrinogen(Fib) and D‐dimer (D‐D) measurement for patients with acute myocardial infarction(AMI) before and after the treatment with the anticoagulation and thrombolysis therapy .Methods 110 patients with AMI were recruited in the study and the plasma hs‐CRP ,Fib ,D‐D and myocardi‐al damage markers were measured before and after the treatment .Results 66 of the 110 patients′plasma hs‐CRP ,Fib ,D‐D concen‐trations elevated(higher than the threshold) before treatment and after treatment within 24 h ,while 44 patients′plasma hs‐CRP , Fib concentrations increased ,but D‐D didn′t .Conclusion The measurement of hs‐CRP is helpful for the diagnosis and treatment of AMI .Hs‐CRP is another good myocardial injury marker ,and the plasma hs‐CRP concentration after treatment for 24 -48 h could reflect the severity and prognosis of AMI better than after treatment within 12 h .Fib decreases relatively slowly after the treat‐ment ,so it cannot be used for curative effect observation for AMI patients;D‐D concentration dosen′t have the determined negative predictive value for the diagnosis of AMI ,so it cannot be used as screening out indicator for AMI ,but D‐D concentration can be used as therapeutic effect monitoring indicator for AMI patients with D‐D positive .