The Prognostic Value Of The Change Over Time Of TNF-a And Hs-CRP Level In Serum After PCI

Obejects: To test the TNF-a and hs-CRP Concentration in Serumof the patients with coronary heart disease,1hours before surgery,24hours after PCI,1weeks after PCI.To study the law of the changesof TNF-A and hs-CRP after PCI.To explore the contact of the rulesand adverse cardiac events.Provide early references for the earlyclinical interventionMethods: A total of70coronary heart disease patients are dividedinto two groups:ACS group (n=30) and SAP group (n=40), and all of themwere operated PCI. And then compared with control group(n=30) who werenormal in coronary arteriography(CAG). We checked the serumconcentrations of hs-CRP and TNF-a before PCI and24h、1week afterPCI by ELISA of all the groups.Compared the results of all the itemsabove and explored their correlations. We also concerned on theoccurrence of major adverse cardiac events(MACE) in these threegroups within6months’visit.Results:1. In ACS group, SAP group and control group before each indexlevel: ACS group HS-CRP and TNF-α level than the SAP group andthe control group increased significantly (P <0.05);No differencein SAP group before or after PCI.(P>0.05).2. Group ACS and group SAP operation indexes before and aftercomparison:1) patients after peripheral hs-CRP, TNF levels weresignificantly higher than before (P <0.05);2) after1weeks of hs-CRP in serum and TNF alpha concentration is24hourspostoperatively compared with preoperative without obvious declinereduce;3) the occurrence of postoperative MACE and not compared withpatients, preoperative peripheral blood hs-CRP, TNF-α leveldifference does not have statistical significance (P>0.05), butthe two groups of patients after1weeks of peripheral blood hs-CRP,TNF-a level difference has statistics significance (P <0.05).3.The serum level of TNF-a was positively correlated with thelevel of hs-CRP (r=0.644,P<0.01).4.Visit result: During six months’ visit, six patientssuffered from MACE, including one myocardial infarction, threerecurrence of angina pectoris, one PCI-again and one death. MACE tookplace in those patients whose serum concentrations of TNF-α、hs-CRPlevels without fall cases after a week.Conclusions:1.PCI, TNF-A, hs-CRP postoperative levels are elevated.2.The serum level of TNF-a is positively correlated with the levelof hs-CRP.3.TNF-α, hs-CRP preoperative levels high, postoperativecontinued to rise, not fall within a week, may be risk factors forpatients after PCI.