C反应蛋白与急性心肌梗死后心功能不全的相关性研究

The relationships between C-reactive protein and acute myocardial infarction-related cardiac dysfunction

目的:探讨C反应蛋白(CRP)与急性心肌梗死(AMI)后心功能不全的关系。方法:选择AMI患者48例(AMⅠ组)、不稳定型心绞痛(UA)患者20例(UA组)和年龄相匹配的健康体检者20例(对照组),采用免疫透射比浊法检测CRP,AMI组检测入院后第1、3、7天的CRP(第1、3、7天的CRP对应CRP1、CRP3、CRP7),不稳定型心绞痛组和对照组各检测1次CRP。根据临床症状体征(Killip分级)和1周后心脏超声心动图评价AMI后心功能状态,以Killip分级将AMI患者分为两个亚组(KillipⅠ级组即心功能正常组和Killip>Ⅰ级组即心功能不全组)。结果:血清CRP在冠心病各组均升高,AMI后不同时间的CRP1、CRP3、CRP7及不稳定型心绞痛组的CRP与对照组比较均有显著性差异(P<0.05)。AMI组CRP1、CRP3、CRP7升高(3次总体有差异,P<0.05),分别以CRP3最高,达峰值。AMI后心功能不全组CRP1、CRP3、CRP7高于AMI后心功能正常组(P<0.01、P<0.01、P<0.05分别对应CRP1、CRP3、CRP7)。结论:冠心病发生、发展有炎症反应的参与,观察CRP水平对于AMI后病情监测和预后具有重要的参考价值。

Objective：To explore the relationships of CRP with heart failure after acute myocardial infarction （AMI）. Methods：This study was carried out in 48 cases of AMI patients （AMI group）,20 cases of unstable angina （UA group） and 20 cases of health check people （control group）. The level of serum CRP was determined by immune turbidimetric method. CRP was detected on the 1st,3rd and 7th day after admission in AMI group （called CRP1,CRP3,CRP7 on the 1st,3rd and 7th day respectively）,while detected only once in UA group and control group. The patients were divided with AMI in -to two subgroups according to the Killip classification （Killlip classⅠnamely not HF group and Killip class〉Ⅰnamely HF group）. Results：The level of serum CRP was significantly higher in the patients with AMI gvoup （each time：CRP1,CRP3,CRP7） and UA group than that in the control group （P〈0.05 respectively）. Among AMI group,CRP of three times were all high and peak on the 3rd day （P〈0.05 on the 1st,3rd and 7th dayrespectively）. In AMI group,CRP was higher in patients with HF than that in patients without HF （CRP adjusted P〈0.01,P〈0.01,P〈0.05 on the 1st,3rd and 7th day respectively）. Conclusion：Inflammation takes part in the course of CHD. CRP level may become an important index for monitoring patients＇ condition and prognosis of AMI.