冠心病支架术前后白细胞、中性粒细胞百分比和C-反应蛋白水平的评价

Valuation of number of leucocyte, percentage of neutrophil and level of CRP before and after PTCA and stenting in CHD patients

目的测定冠心病冠脉成形术(PTCA)联合支架植入术前后外周血白细胞、中性粒细胞百分比及C-反应蛋白(CRP)水平,评价其临床应用价值。方法选择2005年1月1日至2009年1月1日在该院行PTCA和支架植入术患者148例,取支架植入术前、术后1d,术后7d及术后12d肘静脉血,做白细胞、中性粒细胞百分比及CRP的检测,并进行统计学分析。结果冠心病心肌梗死患者PTCA联合支架植入术后的白细胞、中性粒细胞均较术前低,呈递减趋势,且趋于正常,尤其是术后第7天和第12天与术前有显著差异,wilxon符号秩和检验的结果分别为S7=145,P<0.001,S12=5497,P<0.001;术后1d血清CRP水平显著升高,S1=-135,P<0.05;术后1d外周血白细胞数与CRP水平呈显著性正相关r=0.51,P<0.05。结论白细胞、中性粒细胞在评价PTCA联合支架植入术治疗冠心病心肌梗死方面有一定的作用;CRP水平是反映冠心病患者冠状动脉内支架植入术后早期炎性反应及评估病情的敏感指标。

Objective To investigate the number of leucocyte, the percentage of neutrophil and the level of C-reaction protein （CRP） before and after PTCA and stenting therapy, and to evaluate their clinical significance.Methods 148 patients, who received PTCA and stenting therapy from January 1,2005 to January 1,2009 in our hospital, were enrolled in the study. The number of leucocyte, the percentage of neutrophil and the level of CRP were measured before operation and at 1st,7th and 12th day after operation, and statistics analysis was performed.Results The number of leucocyte and the percentage of neutrophil in the patients with acute myocardial infarction （AMI） after operation were lower than those before operation, and decreased gradually to normal level. There was remarkable difference in the number of leucocyte and neutrophil between 7th and 12th day after and before PTCA and stenting. The results of wilxon rank sum test were S7=145 and S12=5 497 respectively （P0.001,P0.001）.The level of CRP increased significantly （S1=-135,P〈0.05） and the number of leucocyte had positive correlation with it at 1st day after operation （r=0.51,P〈0.05）.Conclusion The number of leucocyte and neutrophils had a role in the evaluation of PTCA and stenting therapy in AMI patients. CRP could be a sensitive index, which could reflect early inflammatory response of coronary artery and assess the condition after PTCA and stenting in AMI patients.