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目的:探讨C反应蛋白(CRP)与急性心肌梗死(AMI)后左室重塑的关系。方法:选54例首次确诊单纯前壁AMI患者分别于0、1、2、3、4、5、6天抽血查CRP计算CRP曲线下面积(CRPAUC),3-4天抽血查脑钠肽(BNP),心肌梗死(MI)后2月做超声心动图检查观察左室舒张末期容积指数(LVEDVi),左室收缩末期容积指数(LVESVi),室壁运动指数(WMSI)和左室射血分数(LVEF),根据CRP峰值分为CRP增高组和CRP正常组。设对照组35例,应用回归分析观察CRP峰值(CRPpeak),CRPAUC,BNP与左室重塑性指标的关系。结果:与对照组比较CRP峰值、BNP以及EDVi、ESVi、WMSi、和EF均有显著性差异,P<0.05。CRP增高组与CBP正常组比较,除WMSi外BNP、EDVi、ESVi、EF均有显著性差异。单因素相关分析显示,CRPpeak,CRPAUC和BNP与ESVi、EDVi呈正相关(r值分别为0.738,0.573;0.876,0.714;0.624,0.577),而与EF呈负相关(r值分别为-0.625,-0.824,-0.531),尤以CRPAUC为显著。结论:CRP可以对AMI后左室重塑和左室功能不全强有力的预测因子,是影响预后的指标,CRP易于临床检测,可以为MI危险分层提供有价值的依据。
Objective: To investigate the relationship between C-reactive protein (CRP) and left ventricular remodeling after acute myocardial infarction (AMI). Methods: The area of CRP curve (CRPAUC) was calculated from the first diagnosis of pure anterior wall AMI in 54 patients by CRP at 0, 1, 2, 3, 4, 5, and 6 days, (LVEDVi), left ventricular end-systolic volume index (LVESVi), ventricular wall motion index (WMSI) and left ventricular ejection fraction (LVEDVi) were measured by echocardiography after myocardial infarction The blood fraction (LVEF) was divided into CRP increased group and CRP normal group according to the CRP peak value. The control group of 35 cases, the application of regression analysis of CRP peak, CRPAUC, BNP and left ventricular remodeling index. Results: Compared with the control group, CRP peak, BNP, EDVi, ESVi, WMSi, and EF were significantly different (P <0.05). There were significant differences in BNP, EDVi, ESVi, and EF between the elevated CRP group and the normal CBP group except WMSi. Univariate correlation analysis showed that CRPpeak, CRPAUC and BNP were positively correlated with ESVi and EDVi (r = 0.738, 0.573, 0.876, 0.714, 0.624, 0.577 respectively), but negatively correlated with EF (r = -0.625, 0.824, -0.531), especially CRPAUC was significant. CONCLUSION: CRP can be a powerful predictor of left ventricular remodeling and left ventricular dysfunction after AMI and is an indicator of prognosis. CRP is easy to detect clinically and may provide valuable evidence for MI risk stratification.