脉压指数及c-反应蛋白对急性心肌梗死患者并发室性心律失常的影响

Effect of pulse pressure index and c- reactive protein in patients with acute myocardial infarction complicated ventricular arrhythmia

目的探讨脉压指数(PPI)及C-反应蛋白(CRP)对急性心肌梗死(AMI)患者并发室性心律失常的影响。方法随机选取AMI患者90例,均采用免疫比浊法检测血清CRP水平,同时监测动态血压及动态心电图,参照Lown分级标准分为A组(0级33例)、B组(I级、Ⅱ级)29例和C组(Ⅲ级、Ⅳ级、V级)28例,比较三组患者的PPI及CRP水平;另外,按PPI水平分3组(Ⅰ组:PPI≤0.40,n=26;Ⅱ组:0.41≤PPI<0.50,n=31;Ⅲ组:PPI≥0.50,n=33),分析三组间血清CRP水平及室性心律失常发生情况差异并做相关性分析。结果 (1)C组CRP水平明显高于B组,B组高于A组,差别具有统计学意义(P<0.05)。(2)Ⅲ组CRP水平明显高于Ⅱ组,Ⅱ组高于Ⅰ组,差别具有统计学意义(P<0.05);(3)PPI、CRP与Lown分级相关(r分别为0.385、0.337,P<0.05);PPI与CRP相关(r=0.296,P<0.05)。结论 PPI及CRP增高可能是与AMI并发室性心律失常的易发基础,PPI与CRP存在正相关,通过降低PPI及CRP可以减少AMI患者室性心律失常的发生。

Objective To study the effect of pulse pressure index （PPI） and C - reactive protein （CRP） on patients with acute myocardial infarction （AMI） complicated with ventricular arrhythmia. Methods 0 cases of AMI patients were randomly selected, the level of serum CRP was detected by immune turbidimetry, and dynamic electrocardiogram monitoring and dynamicblood pressure were also recorded. According to the Lown classification criteria, all the patients were divided into A group （0 cases 33 ） , B group （gradeⅠ, gradeⅡ） 29 cases and group C （Ⅲ and Ⅳ grade, Ⅴ grade） in 28 cases, PPI and CRP levels of the patients were compared in the three groups ; In addition, according to the level of PPI, all patients were divided into 3 groups （ group 1 ： PPI = 0. 40, n = 26 ; group II：0.41 = PPI 〈0. 50, n =31 ; group III：PPI =0. 50, n =33）, and the CRP level of ventricular arrhythmia in serum between the three groups, arrhythmia occurrence difference and their correlation were analyzed. Results The level of CRP 1 of group C was significantly higher than that of group B, and the level of CRP 1 of group B was significantly higher than that of group A, the difference was statisti- cally significant （ P 〈 0.05）. The level of CRP 2 of group m was significantly higher than that of group II, and group II was higher than that of group I , the difference was statistically significant （ P 〈 0. 05 ） ; PPI and CRP was correlated with Lown grade （ r = 0. 385, 0. 337, P 〈 0. 05 ） and PPI had relationship with CRP （ r = 0. 296, P 〈 0.05）. Conclusion PPI and CRP may be increased with AMI complicated with ventricular arrhythmia susceptibility, and PPI was positively correlated with CRP. The incidence of ventricular arrhythmia of patients with AMI could be decreased through reducing the expression of PPI and CRP.