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目的:探讨急性心肌梗死患者采用经皮冠状动脉介入(PCI)术前、术后超敏C反应蛋白(hs–CRP)、血浆肿瘤坏死因子α(TNF–α)变化。方法:分别检测广州军区广州总医院一五七分院100例急性心肌梗死患者发病后6~12 h内、PCI术后24 h、48 h、72 h、5 d、7 d时hs–CRP及TNF–α浓度,根据急性心肌梗死患者PCI术后病情情况将其分为有并发症组、无并发症组及死亡组。结果:术后1 d,3组血浆TNF–α水平较术前明显升高,有并发症组及无并发症组患者于术后2 d逐渐下降,死亡组患者于术后1~5 d则呈上升趋势,直至第7天才逐渐下降;组间比较,差异具有统计学意义(P<0.05);三组hs–CRP水平变化相比,差异具有统计学意义(P<0.05)。结论:急性心肌梗死患者血浆TNF–α、hs–CRP水平升高,如其峰值延迟或持续不降则说明患者病情严重,因此可将该指标作为患者预后评价指标。
Objective: To investigate the changes of hs-CRP and TNF-α in patients with acute myocardial infarction before and after percutaneous coronary intervention (PCI). Methods: The levels of hs-CRP and TNF were detected at 6 h, 12 h, 48 h, 48 h, 72 h, 5 d, and 7 d after PCI in 100 patients with acute myocardial infarction in Guangzhou General Hospital of Guangzhou Branch, Guangzhou General Hospital of Guangzhou Branch. -α concentration, according to the condition of patients with acute myocardial infarction after PCI will be divided into a complication group, no complications and death group. Results: The level of plasma TNF-α in group 3 was significantly higher than that in preoperative one day after operation. The number of patients with or without complication decreased gradually from 2 days after operation to 1 to 5 days after operation (P <0.05). The hs-CRP levels in the three groups were significantly different (P <0.05) compared with the control group. The difference was statistically significant (P <0.05). CONCLUSIONS: The levels of plasma TNF-α and hs-CRP in patients with acute myocardial infarction are elevated. If their peak delay or persistence does not decrease, the patient’s condition is serious. Therefore, this index can be used as a prognostic indicator in patients.