【摘要】 目的探讨急性心肌梗死患者经皮冠状动脉介入治疗(PCI)后血清脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)水平与近期预后的相关性。方法选取行PCI术的182例急性心肌梗死患者为研究对象,根据术后3个月内是否发生心血管不良事件将其分为预后不良组58例和预后良好组124例。采用酶联免疫吸附(ELISA)法检测患者血清BNP、hs-CRP、CK-MB水平;分析预后不良患者血清BNP、hs-CRP、CK-MB水平;分析血清BNP、hs-CRP、CK-MB水平对急性心肌梗死PCI后预后不良的预测价值;分析影响PCI患者术后预后不良的因素。结果预后不良组血清BNP、hs-CRP、CK-MB水平高于预后良好组,差异有统计学意义(P <0.05)。预后不良患者血清BNP与hs-CRP、CK-MB水平呈正相关(r=0.527,P <0.05; r=0.541,P <0.05),CK-MB与hs-CRP呈正相关(r=0.511,P <0.05)。血清BNP、hs-CRP、CK-MB及3者联合预测急性心肌梗死PCI后预后不良的曲线下面积(AUC)分别为0.872、0.763、0.921、0.949,特异性分别为87.9%、82.3%、94.4%、93.5%,敏感度分别为74.1%、63.8%、81.0%、87.9%。BNP、CK-MB是影响急性心肌梗死患者PCI后预后不良的独立危险因素(P <0.05)。结论血清BNP、hs-CRP、CK-MB对急性心肌梗死患者PCI后预后不良有一定的预测作用。更多还原

【Abstract】 Objective To investigate the correlations between serum brain natriuretic peptide(BNP),high-sensitivity C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB) and short-term prognosis in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 182 patients with acute myocardial infarction who underwent PCI were selected as the study subjects,and were divided into poor prognosis group(n = 58) and good prognosis group(n = 124) according to the occurrence of adverse cardiovascular events within three months after the operation.The serum levels of BNP,hs-CRP and CK-MB were detected by enzymelinked immunosorbent assay(ELISA); the serum BNP,hs-CRP and CK-MB levels in patients with poor prognosis were analyzed; the predictive value of serum BNP,hs-CRP,CK-MB levels on the poor prognosis of acute myocardial infarction after PCI were analyzed; the factors affecting the poor prognosis of patients with PCI were analyzed.Results The serum levels of BNP,hs-CRP and CK-MB in poor prognosis group were significantly higher than those in good prognosis group(P < 0.05).Serum BNP was positively correlated with hs-CRP and CK-MB levels in patients with poor prognosis(r = 0.527,P < 0.05; r = 0.541,P < 0.05),there was a positive correlation between CK-MB and hs-CRP(r = 0.511,P < 0.05).The area under the curve(AUC) of serum BNP,hs-CRP,CK-MB alone and their combination in predicting poor prognosis after PCI were 0.872,0.763,0.921,0.949,respectively,the specificity were 87.9%,82.3%,94.4%,93.5%,respectively,and the sensitivity was 74.1%,63.8%,81.0% and 87.9%,respectively.NP and CK-MB were independent risk factors for poor prognosis in patients with acute myocardial infarction after PCI(P < 0.05).Conclusion Serum BNP,hs-CRP and CK-MB have a certain predictive effect on the poor prognosis of patients with acute myocardial infarction after PCI.更多还原