急性心肌梗死不同梗死部位及冠脉病变血管血浆hs-CRP及Hcy变化临床观察.docVIP

急性心肌梗死不同梗死部位及冠脉病变血管血浆hs-CRP及Hcy变化临床观察作者单位：650051 昆明医学院附属延安医院? 通讯作者：景舒南 【摘要】 目的 探讨急性ST段抬高型心肌梗死（STEMI）不同梗死部位和冠脉病变血管血浆hs-CRP、Hcy的变化。方法 69例急性心肌梗死患者根据心电图、心肌坏死标记物及冠脉造影分为急性ST段抬高广泛前壁心肌梗死组37例和急下壁心肌梗死组32例。于发病24 h内抽取静脉血行血浆hs-CRP、Hcy检测。结果 急性ST段抬高广泛前壁和下壁心肌梗死早期血浆?hs-?CRP和Hcy均高于正常值，且广泛前壁心肌梗死组的hs-CRP和Hcy要高于下壁心肌梗死组，但两组比较差异无统计学意义（??P??0.05）。结论 hs-CRP和Hcy是急性心肌梗死的危险因素，并且可反映心肌损害和血管病变的程度。? 【关键词】 急性心肌梗死； 冠状动脉狭窄； 高敏C-反应蛋白； 同型半胱氨酸? Clinical observation to different locations of AMI and hs-CRP and Hcy in plasma ?JING Shu-nan, LAI Qi, YANG Fang, et al. Yan?an Hospital of the Kunming Medical University, Kunming 650051, China?? 【Abstract】 Objective To explore the relationship between the different locations of acute myocardial infarction with elevated ST segment(STEMI) as well as coronary narrowing and the levels of high-sensitive C-reactive protein(hs-CRP) and hemoeysteine(Hcy) in plasma.Methods Sixty-nine patients of STMI were divided into group-1(?n?=37, the infarction was located in the wide anterior wall) and group-2(?n?=32, the infarction was located in the inferior wall) by ECG and coronary angiogram. The hs-CRP and Hcy in plasma were tested for all of the patients with venous blood samples taken within 24 hours of the AMI.Results The hs-CRP and Hcy was elevated over the normal level significantly in both of the two groups(?P?0.05).Conclusion Both hs-CRP and Hcy are risk factors of AMI and may reflect the extent of the myocardial injury and coronary narrowing.? 【Key words】 Acute myocardial infarction(AMI); Coronary artery narrowing; High-sensitive C-reactive protein(hs-CRP); Homoeysteine(Hcy)? doi：10.3969/j.issn.1674-4985.2012.06.009 ?? 同型半胱氨酸（Hcy）是一种人体内的含硫氨基酸，为蛋氨酸和半胱氨酸代谢过程中的重要中间产物，是冠状动脉粥样硬化和心肌梗死的危险指标。最新的流行病学及实验室资料表明，血液中Hcy含量升高已成为动脉粥样硬化发生的一个独立危险因子??［1］?，其浓度与血管病变指数或程度呈正相关。C反应蛋白（CRP）作为一种急性期反应蛋白，不仅被认为是一种非常敏感的炎症组织损伤标志物，而且它本身作为一种致炎因子直接参与了局部和全身的炎症进程和动脉粥样硬化形成与发展的所有环节。本文观察了急性ST段抬高广泛前壁和下壁心肌梗死和相应的左前降支（LAD）和右冠脉（RCA）不同病变时高敏C-反应蛋白（hs-CRP）和Hcy的变化有无明显差异，现报道如下。? 1 资料与方法