急性心肌梗死患者PCI后BNP、hsCRP、cTnI的预后意义

Prognostic significance of levels of BNP,hsCRP and cTnI in patients with acute myocardial infarction after PCI

目的:观察急性心肌梗死(AMI)患者经皮冠状动脉成形术(PCI)后脑钠肽(BNP)、高敏C反应蛋白(hsCRP)、心肌肌钙蛋白I(cTnI)水平的预后意义。方法:入选90例行PCI的AMI患者,于PCI后1d、7d测定血浆中BNP、hsCRP、cTnI水平,随访6个月内的主要心脏不良事件(MACE),并与AMI药物治疗患者(45例,药物治疗组),健康体检者(30例,健康对照组)进行对比分析。结果:术后1d,与健康对照组比较,AMI两组患者hsCRP、BNP、cTnI水平均明显升高(P均<0.01),但PCI组和药物治疗组比较无显著差异(P>0.05)。术后7d,与药物治疗组比较,PCI组hsCRP[(13.5±3.3)mg/L比(7.5±0.3)mg/L]、BNP[(2036±135)ng/L比(336±27)ng/L]、cTnI[(7.3±0.3)ng/L比(2.3±0.3)ng/L]水平明显降低(P<0.01),PCI组MACE发生率明显低于药物治疗组(27.8%比46.7%),P<0.01。结论:急诊PCI治疗优于药物治疗,联合检测脑钠肽、高敏C反应蛋白和心肌肌钙蛋白I水平有助于判断急性心肌梗死行PCI患者的预后。

Objective：To observe prognostic significance of levels of brain natriuretic peptide（BNP）,high sensitive C reactive protein（hsCRP）and cardiac troponin I（cTnI）in patients with acute myocardial infarction（AMI）after percutaneous coronary intervention（PCI）.Methods：A total of 90AMI patients undergoing PCI were enrolled,plasma levels of BNP,hsCRP and cTnI were measured after PCI 1dand 7d,and major adverse cardiovascular events（MACE） within six months were followed up.They were compared and analyzed with those of AMI medication patients（n=45,medication group） and healthy subjects（n=30,healthy control group）.Results：Compared with healthy control group after PCI 1d,there were significant increase in levels of hsCRP,BNP and cTnI in two AMI groups（P〈0.01all）,but there were no significant difference between PCI group and medication group,P〈0.01.Compared with medication group after PCI 7d,there were significant decrease in levels of hsCRP [（13.5±3.3） mg/L vs.（7.5±0.3） mg/L ],BNP [（2036±135） ng/L vs.（336±27） ng/L ] and cTnI [（7.3±0.3） ng/L vs.（2.3± 0.3） ng/L ] in PCI group,P〈0.01all.Compared with medication group after PCI six-month,there was significant decrease in incidence rate of MACE（46.7%vs.27.8%） in PCI group,P〈0.01.Conclusion：Emergency PCI is superior to medication.Combined detection of levels of BNP,hsCRP and cTnI contributes to judge prognosis in AMI patients undergoing PCI.