Ma Xiao-juan, Yin Hui-jun, Chen Ke-ji
Department of Cardiovascular Diseases, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.
Chin J Integr Med. 2009 Jun;15(3):236-40. doi: 10.1007/s11655-009-0236-3. Epub 2009 Jul 2.
Acute myocardial infarction (AMI) is still the leading factor causing crippling and death in cardiovascular disease. Percutaneous coronary intervention (PCI) can significantly reduce inpatient mortality and incidence of complication. But owing to the existence of restenosis, in-stent thrombosis, etc., recurrent post-PCI cardiovascular events and high repeatability of hospitalization, as well as its crippling rate and mortality, remain a serious threat to the society and the patients' family. Therefore, the appraisal and intervention in post-PCI associated risk factors has presently become one of the foci in clinical research. To improve the near- and long-term prognosis and quality of life in post-PCI AMI patients, further improvement of the evaluation system in risk factors and prognosis is necessary in order to provide a theoretical basis for early application of intervention in high-risk patients in clinical practice. This thesis mainly dissertates some explicit and valuable factors for clinical prognosis evaluation in recent studies, involving C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP), Chinese medicine (TCM) syndrome, their correlation with clinical state and course of AMI, and their importance in clinical prognosis.
急性心肌梗死(AMI)仍是心血管疾病中导致致残和死亡的主要因素。经皮冠状动脉介入治疗(PCI)可显著降低住院死亡率和并发症发生率。但由于存在再狭窄、支架内血栓形成等问题,PCI术后心血管事件复发以及高住院重复性,连同其致残率和死亡率,仍然对社会和患者家庭构成严重威胁。因此,对PCI术后相关危险因素的评估和干预目前已成为临床研究的重点之一。为改善PCI术后AMI患者的近期和长期预后以及生活质量,有必要进一步完善危险因素和预后评估体系,以便为临床实践中高危患者早期应用干预措施提供理论依据。本论文主要论述近期研究中一些对临床预后评估有明确且重要价值的因素,涉及C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、脑钠肽(BNP)、心钠肽(ANP)、中医证候,它们与AMI临床状态和病程的相关性以及在临床预后中的重要性。