C反应蛋白对急性冠状动脉综合征转归的预测价值

目的研究人体血清中C反应蛋白(CRP)的含量对急性冠状动脉综合征(ACS)转归预测的可靠性、敏感性及作为临床疗效判定指标的可行性。方法选择冠心病患者156例,按临床分型分为稳定型心绞痛组(SAP)54例,不稳定型心绞痛组(UAP)48例,急性心肌梗死组(AMI)44例,选择正常人50例为对照组。测定各组血清CRP含量,并动态观察ACS患者CRP的变化,按治疗效果分为稳定组和恶化组,对比分析各组间CRP含量的差异。结果SAP组的患者血清中CRP含量有所增高,但与对照组比较无显著性差异(P>0.05)。对照组和SAP组与UAP及AMI组比较在CRP含量上具有非常显著性差异(P<0.01),即UAP组和AMI组的患者血清中CRP含量明显增高,高于对照组和SAP组。而UAP组与AMI组比较在CRP含量上具有显著性差异(P<0.05),即AMI组患者血清中CRP含量明显高于UAP组。ACS组患者在入选的第1d和第2d血清中CRP含量无明显差异,从第5d起稳定组患者血清中CRP含量逐渐下降,而恶化组患者血清中CRP含量逐渐升高,两组间比较从显著性(P<0.05)到极显著性差异(P<0.001)。结论ACS患者随着病情的稳定血清CRP的含量逐渐下降,而随着病情的恶化血清CRP含量逐渐增加,可作为ACS患者预后判断的早期指标。

Value of C-reactive proteim on prognosis of the acute coronary syndrome

Objctive To study the reliability and sensitivity of CRP on the prognosis forecast of acute coronary syndrome and the feasibility on judging curative effect. Methods 156 cases with coronary artery disease were selected and divided into SAP group (54), UAP group (48), AMI group (44). Healthy people were selected as control group (50) .The serum level of CRP was measured in every groups and the change of serum level of CRP was observed ambulatly in acute coronary syndrome, according to curative effect, divided into worsen and stable groups.The compare analysis was made in every groups. Results The level of CRP was increased lightly in SAP group, but was no significant difference compare with control group(P>0.05).The serum level of CRP in UAP and AMI grpups was higher obviously than that in SAP group(P<0.01).The serum level of CRP in AMI group was higher than that in UAP group, the difference was signicant(P<0.05).The serum level of CRP was not significant in acute coronary syndrome in first and second day, but was decreased in stable group and was increased in worsen group from fifth day. The difference was from significant to very significant between two groups. Conclusion The serum level of acute coronary syndrome to changed following patient’s condition, and it may be a index as early judging prognosis of ACS.