C反应蛋白对急性心肌梗死后左室重塑影响的临床研究

The relationship between C-reaction protein and left ventricular remodeling after acute myocardial infartion

目的:探讨C反应蛋白(CRP)与急性心肌梗死后左室重塑的关系。方法:选54例首次确诊单纯前壁急性心肌梗死患者于入院当天抽血查CRP以及心肌梗死后2月做超声心动图检查观察左室舒张末期容积指数(LVEDV i),左室收缩末期容积指数(LVESV i),室壁运动指数(WMSI)和左室射血分数(LVEF),根据CRP〉8 mg/L分为CRP增高组和CRP正常组。结果:与正常组比较CRP以及EDV i、ESV i、WM-S i、和EF均有显著性差异,P<0.05。CRP增高组与CRP正常组比较,除WMS i外BNP、EDV i、ESV i、EF均有显著性差异。单因素相关分析显示,CRP与ESV i、EDV i呈正相关(r值分别为0.738,0.573),CRP与EF呈负相关(r为-0.625)。结论:CRP可以对AM I后左室重塑和左室功能不全强有力的预测因子,是影响预后的指标,CRP易于临床检测,可以为心肌梗死危险分层提供有价值的依据。

Objective： To discuss the relationship between C -reactive protein（CRP） and left ventricular remodeling. Methods： We prospectively studied 54 consecutive patients with a first acute anterior AMI, who received thrombolytic treatment and recanalized. We measured plasmas C - reaction protein （ CRP ） level when patients admitted, we measured left ventricular end - diastolic volume index （EDVi） ,end- systolic volume index （ESVi） ,wall marion score index （WMSI） and ejection fraction（EF） by Echocardiography after 2 month. According to CRP（8mg/l） they were divided into the following groups： CRP elevated group and CRP normal group. Results： Compared with control group, CRP,EDVi and EDSi were higher （ P 〈0.05 ） and WMSI ,EF were lower （ P 〈0.05）. Compared with CRP normal group, EDVi and ESVi were higher （P 〈0.05 and P 〈0. 01 ） ,but EF was lower （P 〈0.05）. Correlation analysis showed that CRP is positively correlated with ESVi and EDVi （ r = 0. 738 ;0. 573 respectively, all P 〈 0. 05 ） and inversely correlated with EF （ r = - 0. 625 ）. the CRP showed the best correlation. Conclusions： Plasma CRP is strong predictors of remodeling and LV dysfunction and effect AMI prognosis . CRP is measured easily and usefully in clinic thus, CRP levels may provide information for long - term risk stratification after MI.