急性心肌梗死血清超敏C-反应蛋白的变化及临床意义

Variations and clinical significance of seum super-sensitive C-reactive protein in patients with acute myocardio infarction

目的探讨急性心肌梗死(AMI)患者血清超敏C-反应蛋白(hs-CRP)水平的变化及其与心肌损伤指标和冠状动脉粥样硬化程度的关系。方法对158例AMI患者分别在入院的第1、3、7、14d进行hs-CRP的定量检测以及肌酸磷酸激酶MB(CK-MB)和肌钙蛋白Ⅰ(cTnI)的同步浓度测定,并对其中81例AMI患者的冠状动脉造影结果,采用Gensini评分系统对冠状动脉粥样硬化程度进行定量评分。血清hs-CRP采用胶乳增强免疫透射比浊法进行检测。用统计学方法分析hs-CRP的水平变化以及与CK-MB、cTnI和冠状动脉粥样硬化狭窄程度的相关性。结果hs-CRP高峰出现在AMI早期;hs-CRP水平与CK-MB和cTnI呈正相关(r=0.61,P<0.01;r=0.69,P<0.01);hs-CRP与Gensini积分呈正相关。结论血清hs-CRP对AMI的早期诊断具有较高的应用价值,其水平可反映病情的严重程度,对AMI的病变程度具有预测价值。

Objective To detect the concentration of serum high -sensitivity C -reactive protein （hs-CRP） and inves-tigate its correlation with myocardial injury markers and coronary artery stenosis in acute myocardial infarction （ AMI ）. Methods The concentrations of hs - CRP,CK - MB and cTnI were simultaneously determined on the lth,3th,7th and 14th day of hospitalization. The level of serum high - sensitivity C - reactive protein was determined by a latex enhanced immuno-turbidimetric assay. The severity of coronary atherosclerosis was defined by the Censini＇s score system after having underwent coronary angiography and evaluated the correlation by statistical method. Results The peak concentration of hs - CRP was in the early AMI;The level of hs-CRP was positively correlated with CK- MB,cTnI and Gensini＇ s score （P 〈0.01 ）. Conclusion The hs - CRP is of high value in diagnosis of AMI in its early stage. The concentration of hs - CRP is signifi-cantly associated with the severity of coronary artery stenosis.