超敏C反应蛋白对急诊经皮冠状动脉介入术后患者预后的预测价值被引量：11

Value of hypersensitive C-reactive protein for predicting the prognosis of patients after emergent percutaneous coronary intervention

下载PDF

导出

摘要目的评价超敏C反应蛋白（hypersensitive C-reactive protein，hs—CRP）对ST段抬高急性心肌梗死（ST elevation myocardial infarction，STEMI）经皮冠状动脉介入（percutaneous coronary intervention，PCI）术后180d主要心脏不良事件（major adverse cardiac event，MACE）的预测价值。方法216例初发STEMI入院时测定hs—CRP，发病12h内急诊行PCI。根据hs—CRP水平，分为hs—CRP升高组（hs—CRP〉3mg／L，n=52）和hs—CRP正常组（hs—CRP≤3ms／L，n=164），随访所有人选患者术后180 d MACE发生率。结果患者年龄、高血压病史、血脂异常、梗死部位、冠脉病变程度及PCI即刻成功率各组间无明显差异（P〉0．05），hs—CRP升高组左心室射血分数低于hs—CRP正常组，WBC和肌酸激酶同工酶峰值显著高于hs—CRP正常组（P〈0．05）；急诊PCI术后180dhs—CRP升高组MACE发生率均明显高于hs—CRP正常组（22．0％VS．9．6％，P=0．048）。多因素分析显示，人院时hs—CRP水平是STEMI患者急诊PCI术后180 d MACE（OR：2．82，95％CI 1．28～5．83，P=0．021）的独立预测因素。结论入院时hs—CRP升高是STEMI患者急诊PCI术后180 d MACE的相对独立危险因素。 Objective To evaluate the value of hypersensitive C-reactive protein （hs-CRP） for predicting the incidence of major adverse cardiac events （MACE） in patients with acute myocardial infarction （AMI） within 180 days after percutaneous coronary intervention （ PCI）. Methods The study comprised 216 consecutive patients with first attack of ST-elevation myocardial infarction （ STEMI）. They underwent primary PCI within 12 hours after the onset of chest pain. According to their serum levels of hs-CRP, these patients were divided into two groups： the High hs-CRP Group （〉3 mg/L, n =52） and the Normal hs-CRP Group （ ≤ 3 mg/L, n = 164）. The incidence of MACE within 180 postoperative days was followed. Results There were no significant differences in age, hypertension, hyperlipidemia, left ventricle ejection fraction （LVEF）, creatine kinase isoenzyme MB （CK-MB）, and immediate success rate of PCI between the two groups （ P 〈 0.05 ）. The WBC count was higher in the High hs-CRP Group than in the Normal hs- CRP Group （P 〈0.05）. Follow-up for 180 days showed the High hs-CRP Group had significantly higher incidence of MACE than the Normal hs-CRP Group （22.0% vs 9.6% , P = 0. 048）. Binary logistic regression analysis indicated that high concentration of hs-CRP remained an independent predicator of MACE within 180 postoperative days （ OR = 2.82, 95% CI = 1.28 - 5.83, P = 0. 021 ）. Conclusions High concentration of hs-CRP when admission is a useful predictor for the incidence of MACE in patients with STEMI within 180 days after primary PCI.

作者李蕾郭艳红王贵松郭丽君张福春高炜

机构地区北京大学第三医院心内科北京大学心血管研究所

出处《中国微创外科杂志》 CSCD 2006年第7期483-485,共3页 Chinese Journal of Minimally Invasive Surgery

基金 "十五"国家攻关课题课题编号:2004BA714714B05-01

关键词急性心肌梗死超敏C反应蛋白经皮冠状动脉介入主要心脏不良事件 Acute myocardial infarction Hypersensitive C-reactive protein Percutaneous coronary intervention Major adverse cardiac event

分类号 R542.22 [医药卫生—心血管疾病]

引文网络
相关文献

参考文献12

1Juan CK.Pathophysiology and management of patients with chest pain and normal coronary arteriograms(cardiac syndrome X).Circulation,2004,109:568-572.
2Ridker PM,Rifai N,Rose L,et al.Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.N Engl J Med,2002,347:1557-1565.
3Albert CM,Ma J,Rifai N,et al.Prospective study of C-reactive protein,homocysteine,and plasma lipid levels as predictors of sudden cardiac death.Circulation,2002,105:2595-2599.
4Marrow DA,Rifai N,Antman EM,et al.C-creative protein is a potent predictor of mortality independent of and in combination with troponin T in acute coronary syndromes:a TIMI 11A substudy.J Am Coll Cardiol,1998,31:1460-1465.
5Antman EM,Anbe DT,Armstrong PW,et al.2004 ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction.http://www.acc.org/clinical/guidelines/stemi.
6Schillinger M,Exner M,STEMIghi J,et al.Joint effects of C-reactive protein and glycated hemoglobin in predicting future cardiovascular events of patients with advanced atherosclerosis.Circulation,2003,108:2323-2328.
7Rafan N,Riderk PM,Stamper M,et al.Inflammation and risk of cardiaovascular diseases in apparently health men.N End J Med,1997,97:425-428.
8Pasceri V,Chang JT,Yeh ET.Modulation of C-reactive protein-mediated monocyte chemoattractant protein-1 induction in human endothelial cells by anti-atherosclerosis drug.Circulation,2001,103:2531-2534.
9Sano T,Tanaka A,Namba M,et al.C-reactive protein and lesion morphology in patients with acute myocardial infarction.Circulation,2003,108:282-285.
10Pasceri V,Willerson JT,Yeh ET.Direct proinflammatory effect of C-reactive protein on human endothelial cells.Circulation,2000,102:2165-2168.