| Objective: To investigate the changing and significance of plasma tumor necrosis factor-alpha (TNF-α) and high sensitivity C-reactive protein (hsCRP) in acute myocardial infarction (AMI) patients with emergency Percutaneous Coronary Intervention (PCI).Methords: Plasmic level of TNF-αand hsCRP in 50 AMI patients were assaied within onset 6～12h of AMI(before PCI) and at 24h, 48h, 72h, 5d, 7d and 14d by Enzyme-linked immunosorbent assay (ELISA). The AMI group was divided into 3 sub-groups: the death group, the complication group and the no complication group. Meanwhile, the plasmic level of the two inflammatory factors in 25 controls also were detected before coronary artery angiography .Results: l. Plasmic level of TNF-αand hsCRP at pre-operative were higher in patients with AMI than the controls, respectively TNF-α(119.4±67.58)ng/L vs (19.64±7.55)ng/L and hsCRP (1.43±0.93)mg/L vs (0.52±0.16)mg/L (each P<0.01);2. The plasmic concentration of TNF-αand hsCRP was positively correlated with Gensini score, the higher Gensini score, the more obvious the concentration of TNF-αand hsCRP was increased.3. In the three sub-groups, plasmic concentrations of TNF-αat post-operative first day were markedly higher than at pre-operative. The complication group and the no complication group had already decreased on 2 day, but the death group which was not increased until on 5 day began to decrease on 7 day. On 14 day the complication group and no complication group had alreadyly lowed to pre-operative level, but the death group was still higher than pre-operation level. Among three groups, the differenet time points and the interaction of among groups and the different time points, the each differences were statistically significance.4. In the three sub-groups, plasmic levels of hsCRP had already also began to increase after one day, the peak value concentrations of the no complication group and the death group had been reached by 3 day, then decreased gradually, but the more serious in condtions, the slower in decline. Among three groups, the different time points, the interaction of among groups and the different time points, the differences were statistically significance.5. The concentration's comparision of TNF-αand hsCRP in patients with the complication group and no complication group. In complication group, the concentration of TNF-αreached to the peak value after 24h post-operation, followed by slow decline, were still significantly higher than the no complication group on 14d, the difference was statistically significance (P<0.05). In no complication group, the concentration of TNF-αalso reached to its peak value at 24h post-operation, but its concentration rapidly declined and had alreadily decreased to normal on 5d. In complication group, the concentration of hsCRP reached its peak value in the 3d and subsequently decreased slowly, were still significantly higher on 14d, but the concentraion of the no complication group decreased to normal on 7d.Conclusions: 1. The plasmic concentrations of TNF-αand hsCRP significantly increased in patients with AMI, if their peak did not fall or continued to delay, it implied that the condition was very serious. The determination of TNF-αand hsCRP in patients with AMI could have evident predictive value for long-term or short-term prognosis after emergency PCI.2. The plasmic levels of TNF-αand hsCRP were observative dynamicly in patients with AMI, which would be used as a predictive marker for assessing the clinical conditions and the development of cardiovascular events. It is also very important significance for guiding clinical intervention early and timely and preventing complications to take place...
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