高敏C-反应蛋白在雷帕霉素药物洗脱支架和裸支架植入急性心肌梗死患者中的预后意义

The prognostic value of high sensitivity C-reactive protein after implantation of sirolimus drug-eluting stents and bare stents in acute myocardial infarction patients

目的初步探讨ST段抬高心肌梗死（STEMI）患者植入雷帕霉索药物洗脱支架（Cypher支架）和裸支架后，血清高敏C-反应蛋白（ha—CRP）水平的变化以及对判断预后的意义。方法226枚Cypher支架（Cypher支架组）和102枚裸支架（裸支架组）在急诊经皮冠状动脉介入（PCI）治疗时植入梗死相关动脉。在术前、术后8h和术后24h取静脉血测量血清hs—CRP。结果Cypher支架组和裸支架组患者术前和术后血清hs—CRP各时间点差异无统计学意义（P〉0．05）。术后随访12个月，有主要心血管事件患者与无主要心血管事件患者相比，血清hs—CRP术前差异无统计学意义（P〉0．05），但术后8h和术后24h差异有统计学意义（P（0．05），其中在有无主要心血管事件上，Cypher支架组内在各时间点血清hs—CRP差异无统计学意义（p〉0．05），裸支架组内在术后8h和术后24h血清hs—CRP差异有统计学意义（P〈0．05）。结论急诊PCI治疗植入裸支架的STEMI患者。术后8h和术后24h血清hs—CRP升高，12个月后主要心血管事件增多；急诊PCI治疗植入Cypher支架的STEMI患者，12个月后主要心血管事件与血清hs—CRP升高无明显关系。

Objective To investigate the prognostic value of high sensitivity C-reactive protein （hs-CRP） after implantation of sirolimus dmg-eiuting stents （Cypher stents） and bare stents in acute myocardial infarction patients. Methods Two hundred and twenty-six Cypher stents （Cypher stcnts group）and 102 bare stents （bare stents group）were implanted in infarction-related arteries during emergency percutaneous coronary intervention （PCI）therapy.The blood samples were obtained just before operation and after operation at g-hour and 24-hour to detect the level of hS-CRP. Results There was no difference of hs-CRP levels between Cypher stents group and bare stents group at different time （P 〉 0.05）.At 12-month follow-up after operation,although there were no difference of baseline hs-CRP level （P 〉 0.05）, hs-CRP levels after PCI operation at 8-hour and 24-hour were statistically different between main accidents of cardiac events （MACE） group and non-MACE group（P 〈 0.05 ）.The bare stents group also had the same result,but the Cypher stents group didn＇t have. Conclusions The elevation of hs-CRP level at 8-hour and 24-hour after emergency PCI therapy operation is associated with one-year MACE in bare stents group,but nol in Cypher stents group.