Tsakiris Alexandros K, Marnelos Panagiotis G, Nearchou Nearchos S, Papadakis John E, Karatzis Emmanouil N, Skoufas Panagiotis D
1st Cardiology Department, Hellenic Red Cross Hospital-Korgialeneio-Benakeio, Athens, Greece.
Hellenic J Cardiol. 2006 Jul-Aug;47(4):218-22.
Inflammation plays a crucial role in atherosclerotic processes and in acute coronary syndromes (ACS). Strong evidence of this is the elevation of C-reactive protein (CRP) serum levels during an ACS and its short- and long-term prognostic potency. The present study aimed to assess the relation between CRP serum levels and the elevation of cardiac markers in patients with ST elevation acute myocardial infarction (STEMI) as well as the effect of intravenous thrombolysis on a time series of CRP values.
Thirty-six patients with STEMI were enrolled in the study. Twenty-eight of them received intravenous thrombolysis successfully and 8 did not receive thrombolysis. We measured serum concentrations of CRP, troponin I, creatine kinase, creatine kinase isoenzyme and lactate dehydrogenase in all patients on admission, 24 and 48 hours later. CRP serum values were obtained using the turbidimetric method. Coronary angiography was performed in all patients to estimate disease severity and culprit vessel flow after treatment.
Patients who were thrombolysed had lower CRP values on admission (p < 0.05), at 24 hours (p < 0.001) and 48 hours later (p < 0.05), compared to those without thrombolysis. CRP values on admission had a positive correlation with markers of cardiac myocyte necrosis and a negative correlation with TIMI flow.
Thrombolytic therapy in patients with STEMI is associated with a less pronounced response of CRP during the first 48 hours. The close relation of CRP with cardiac enzymes and troponin I on admission adds to the proven value of this inflammatory marker and suggests directions for further research.
炎症在动脉粥样硬化进程和急性冠状动脉综合征（ACS）中起关键作用。有力证据是ACS期间C反应蛋白（CRP）血清水平升高及其短期和长期预后效力。本研究旨在评估ST段抬高型急性心肌梗死（STEMI）患者CRP血清水平与心脏标志物升高之间的关系，以及静脉溶栓对CRP值时间序列的影响。
36例STEMI患者纳入本研究。其中28例成功接受静脉溶栓，8例未接受溶栓。在所有患者入院时、24小时和48小时后测量CRP、肌钙蛋白I、肌酸激酶、肌酸激酶同工酶和乳酸脱氢酶的血清浓度。采用比浊法获得CRP血清值。对所有患者进行冠状动脉造影以评估治疗后疾病严重程度和罪犯血管血流。
与未溶栓患者相比，溶栓患者在入院时（p < 0.05）、24小时（p < 0.001）和48小时后（p < 0.05）的CRP值较低。入院时CRP值与心肌细胞坏死标志物呈正相关，与TIMI血流呈负相关。
STEMI患者的溶栓治疗与最初48小时内CRP反应不明显有关。入院时CRP与心脏酶和肌钙蛋白I的密切关系增加了这种炎症标志物的已证实价值，并为进一步研究指明了方向。
