| ObjectiveTo explore the characteristics of coronary artery lesions in patients with acute myocardial infarction(AMI) in different levels of high sensitivity C-reactive protein(hs-CRP)and procalcitonin(PCT). To evaluate the predictive value of PCT and hs-CRP on the clinical outcome by analyzing the association between hs-CRP, as well as PCT, and hepatic function, renal function, cardiac function and adverse events during hospitalization.MethodsA total of 187 patients with AMI in our hospital from October 2013 to October 2014 were divided into two subgroups according to the level of hs-CRP and the level of PC T. 69 cases were in normal PCT group, 118 cases in high PCT group(PC T>0.046 ng/ml); 100 cases were in normal hs-CRP group, 87 cases in high hs-CRP group(hs-CRP>5 mg/L). Information of all the patients was collected. General information: gender, age, smoking, drinking, previous history(hypertension, diabetes, intracoronary stent implantation), course of disease(hypertension, diabetes) and blood pressure on admission; Assay index: PCT, hs-CRP, SOD, ALT, AST, C ys-C, BUN, CREA, U-ALB, UA, TC, TG, HDL, LDL, GLU, TNI and BNP; Ultrasonic cardiogram index: EF, FS; Coronary angiogram results: the range of coronary artery lesions, the degree of coronary artery stenosis, ang the infarct-related artery(IRA); Adverse events during hospitalization: the formation of the ventricular aneurysm, cardiogenic shock, mortality. The SPSS17.0 statistical software was used for data analysis.ResultsComparison of general data in PCT subgroups and hs-CRP subgroups respectively: Neither in PCT subgroups nor in hs-CRP subgroups there were any significant difference in age, man, smoking rate, drinking rate, hypertension, type 2 diabetes, course of hypertension, course of diabetes, systolic pressure on admission, diastolic pressure on admission(P>0.05).Correlation between hs-CRP and indexes of patients with AMI was showed by spearman correlation analysis. hs-CRP was positively correlated with PCT, TNI, BNP, CREA, AST(P<0.05); hs-CRP was negatively correlated with SOD, EF, FS, TC, TG(P<0.05); But for hs-CRP, there were no significant relationship to C ys-C, BUN, UA, ALT, HDL, LDL or GLU(P>0.05).Spearman correlation analysis showed that PCT was positively correlated with hs-CRP, TNI, BNP, C ys-C, BUN, CREA, AST(P<0.05); PCT was negatively correlated with SOD, EF, FS(P<0.05); But for PCT, there were no significant relationship to UA, ALT, TC, TG, HDL, LDL or GLU(P>0.05).Comparison of coronary artery lesions in PCT subgroups and hs-CRP subgroups respectively: there were no statistical difference in the range of coronary artery lesions, the degree of coronary artery stenosis, IRA, the previous history of percutaneous coronary intervention or cases without surgery in PCT subgroups and hs-CRP subgroups(P>0.05).Comparison of clinical indicators in hs-CRP subgroups in patients with AMI: C ys-C, CREA and BNP were significantly rised in high hs-CRP group compared with normal hs-CRP group(P<0.05), EF and FS significantly dropped(P<0.05) and cases of cardiogenic shock increased(P<0.05); There were no statistical difference of ALT, BUN, U-ALB, UA, cases of Killip â…¢-â…£, formation of the ventricular aneurysm or mortality in hs-CRP subgroups, but the case of BUN that have rised increased in high hs-CRP group(P<0.05).Comparison of clinical indicators in PCT subgroups in patients with AMI: Cys-C, BUN, CREA and BNP were significantly rised in high PC T group compared with normal PCT group(P<0.05), while EF and FS were significantly dropped(P<0.05), cases of cardiogenic shock and cases of K illip â…¢-â…£increased(P<0.05); There were no statistical difference of ALT, U-ALB, UA, the formation of the ventricular aneurysm or mortality in PCT subgroups.In hs-CRP subgroups, 7 in 187 patients with AMI were cardiogenic shock which were distributed in high hs-CRP group, 1 case in normal hs-CRP group; In PCT subgroups, all of the 8 cardiogenic shock were distributed in high PCT group. In hs-CRP subgroups, 3 cases of the formation of the ventricular aneurysm were distributed in high hs-CRP group, 2 cases in normal hs-CRP group; In PCT subgroups, all of the 5 formation of the ventricular aneurysm were distributed in high PCT group.ConclusionThere was obvious relationship between PCT and hs-CRP, so they can be combined detection to judge the degree of inflammatory reaction clinically in patients with AMI.Blood lipid was correlated with hs-CRP in patients with AMI, but not with PCT. The degree of inflammatory reaction could not be represented by the level of b lood lipid; Neither PCT nor hs-CRP had any significant correlation with GLU, so the value of inflammatory reaction was not clear in the level of GLU in patients with AMI.Both hs-CRP and PCT were correlated with renal dysfunction, but PCT maybe better than hs-CRP for clinical value in mild renal disfunction and prerenal damage.Both hs-CRP and PCT were correlated to cardiac insufficiency and cardiogenic shock; Neither PCT nor hs-CRP had statistical correlation of the formation of the ventricular aneurysm or mortality; The rise of PCT maybe better than hs-CRP in predicting cardiac insufficiency, while PCT in normal level maybe superior to hs-CRP in excluding cardiogenic shock or the formation of the ventricular aneurys.Neither PCT nor hs-CRP can reflect the characteristic of the range of coronary artery lesions, IRA or the degree of coronary artery stenosis. |
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