冠状动脉介入治疗急性心肌梗死患者血清胆红素和超敏C-反应蛋白变化

Observation on the changes of serum bflirubin and high-sensitivity C-reactive protein in acute myocardial infarction patients after percutaneous coronary intervention

目的观察经皮冠状动脉介入（PCI）治疗急性心肌梗死（AMI）患者血清胆红素（BIL）和超敏C-反应蛋白（hs—CRP）的变化。方法介入组60例AMI患者于发病6h内行急诊PCI治疗，测定患者术前、即刻、术后6、12、24、72h及7d的hs—CRP、血清总胆红素（TBil）、直接胆红素水平（DBil）、间接胆红素（IBil），同时选取30例健康体检者为健康对照组，并进行分析比较。结果介入组血清hs—CRP术后6、12、24、72h及7d均高于健康对照组（t=4．418、7．462、8．434、12．254、7．746，均P〈0．05），术前血清TBil、DBil、IBil均低于健康对照组（t=-4．396、-3．330、-2．901，均P〈0．05），其它各时间点与健康对照组差异均无统计学意义（均P〉0．05）；hs—CRP与BIL无直接相关（r=0．44，P〉0．05）。结论PCI治疗AMI患者，血清hs—CRP和BIL水平随时间呈动态变化，在术后渐恢复正常水平，两者并无相关性，但作为随访指标对疾病的转归有重要意义。

Objective To observe the changes of serum bilirubin（BtL） and high-sensitivity C-reactive protein（hs-CRP） after percutaneous coronary intervention（PCI） in acute myocardial infarction（AMI） patients. Methods The TBiI, [Bil, DBil and hs-CRP levels in serum were detected in 60 AMI patients within 6 hours after attack with immunoturbidimetry before PCI, at the point of operation ,6h, 12h ,24h ,72h and 7d after PCI. 30 healthy persons were chosen as normal control. The two groups were compared. Results The hs-CRP level was increased gradually with time in AMI patients after PCI. The peak value was at 72h after PCI and it was significantly higher than those in the normal group（ P 〈0.05 ）. The TBil ,IBil, DBil levels at pre-PCI point were significantly lower than the normal group （P 〈 0.05）. These index were gradually recovered to the normal group and no significancet differences between them （P 〉 0.05 ）. The coefficient correlation of hs-CRP and TBil, IBil, DBil were 0.44 （ P 〉 0.05 ）. Conclusion The TBil, IBil, DBil and hs-CRP levels in short time after attack of AMI with PCI presented a dynamic changing and recovered to the normal level. No associativity was observed between them, but as the follow-up index, it was significant for the disease turnover.