C-反应蛋白在急性心肌梗死中作用及其预测价值.doc

C-反应蛋白在急性心肌梗死中作用及其预测价值 　【摘要】 目的 探讨C-反应蛋白（C-reactive protein,CRP）对急性心肌梗死（acute myocardial infarction,AMI）发生、发展及预后的影响以及与心血管其他危险因素的相关性。方法 （1）AMI组患者分别于急性发作期和病情好转稳定期第30天抽静脉血，测定心肌酶、超敏C-反应蛋白（hsCRP）。（2）不稳定型心绞痛（UAP）、稳定型心绞痛（SAP）组患者分别于入院即刻、第2天清晨空腹抽取静脉血测定心肌酶、hsCRP。正常对照组（Nor）同样空腹抽取静脉血测心肌酶、hsCRP。CRP低水平表达的冠心病患者hsCRP优于常规CRP检测。（3）对上述所有人员进行血常规检查。结果 （1）在Nor、SAP、UAP、AMI 4组中，hsCRP逐渐增高。其中4组hsCRP比较：除SAP与Nor相比差异无统计学意义（Pgt;0.05）外，其余各组间相比差异均有统计学意义（P均＜0.01)。（2）AMI患者急性发作期血清hsCRP水平明显高于正常对照组（P＜0.01)。在急性心肌梗死稳定期hsCRP水平与正常组对照进行比较差异无统计学意义（Pgt;0.05）。（3）相关分析：hsCRP与肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、白细胞（WBC）、中性粒细胞呈正相关。结论 CRP随着CHD的发展而增高，可能参与动脉硬化的形成，影响了AMI的发生、发展和预后，且对其发展和预后有判断和预测价值。 【关键词】 C-反应蛋白 急性心肌梗死 炎症 ［Abstract］ Objective To investigate the relationship between the levels of plasma C-reactive protein（CRP）and acute myocardial infarction（AMI）.To observe the relationship between the levels of CRP and the major risk factors of AMI.Methods （1）The hsCRP and CK concentrations were tested in 30 patients with acute myocardial infarction and in 30 cured patients on the 30th day of stable phase of AMI.（2）The hsCRP and CK concentrations were tested in 31 unstable angina pectoris (UAP)，38 stable angina pectoris(SAP) and 40 normal persons (Nor).（3）To measure the values of white cell count in all patients.Results （1）The plasma hsCRP concentrations were gradually increasing in Nor group，SAP group，UAP group，and AMI group.There were significant differences each other except the hsCRP level of Nor group and SAP group.（2）The levels of hsCRP of patients with AMI in period of onset were significantly higher than those healthy adults（P＜0.01）。The levels of hsCRP had no significant difference between cured patients on the 30th day of stable phase of AMI and healthy adults（Pgt;0.05）.（3）Correlation analysis： There were positive relationships between hsCRP and white cell count，CK，CK-MB.Conclusion The levels of hsCRP are gradually increasing according to the disease degrees and can be used as a predictor of the prognosis of AMI.hsCRP is