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目的观察不稳定型心绞痛(UAP)患者接受冠状动脉介入术(PCI)治疗前后C-反应蛋白(CRP)及肌钙蛋白I(cTnI)的变化及其对预后的预测价值。方法选择2002年3月至2004年12月在广东省江门市人民医院住院并接收PCI治疗的87例UAP患者,术前及术后1,12,24,48h分别测定血浆CRP及cTnI水平,并分析术前术后的变化,将PCI术后12hCRP>3.0mg/L、cTnI>2.0μg/L的65例患者作为A组;其他22例为B组作对照,分析CRP、cTnI与冠脉病变程度,球囊扩张次数、压力、时间、支架置入数及合并症的关系,观察CPR、cTnI的水平与住院期间及随防1年患者恶性心脏事件发生率的关系。结果87例UAP患者PCI治疗后,CPR、cTnI均明显升高(P均<0.05)。CPR、cTnI与冠脉病变的程度,球囊扩张的次数、压力、时间、支架置入数及合并症呈正相关。(A组与B组比较,P<0.05),A组住院期间及随防期间恶性心脏事件的发生率显著高于B组(P<0.05)。结论PCI治疗会引起UAP患者炎症激活及心肌损伤,且对术后的临床预后有一定的预测价值。
Objective To investigate the changes of C-reactive protein (CRP) and troponin I (cTnI) in patients with unstable angina pectoris (UAP) before and after coronary intervention (PCI) and their prognostic value. Methods Eighty-seven patients with UAP who were hospitalized and received PCI from March 2002 to December 2004 in Jiangmen People’s Hospital of Guangdong Province were enrolled. Plasma CRP and cTnI levels were measured before and after operation at 1, 12, 24 and 48 hours respectively Sixty-five patients with CRP> 3.0mg / L and cTnI> 2.0μg / L at 12h after PCI were selected as group A. The other 22 patients served as control group. The levels of CRP, cTnI and coronary artery disease Degree of balloon dilatation, pressure, time, the number of stent placement and complications, the relationship between the level of CPR and cTnI during hospitalization and with the incidence of malignant cardiac events in patients with 1 year were observed. Results 87 cases of UAP patients after PCI, CPR, cTnI were significantly increased (P all <0.05). The levels of CPR and cTnI were positively correlated with the degree of coronary artery disease, the number of balloon dilation, pressure, time, stent placement and complications. (P <0.05 in group A and group B). The incidence of malignant cardiac events during hospitalization and with prevention in group A was significantly higher than that in group B (P <0.05). Conclusion PCI can cause inflammatory activation and myocardial injury in patients with UAP, and has certain predictive value for postoperative clinical prognosis.