心肌肌钙蛋白T和C-反应蛋白与不稳定型心绞痛的关系

目的检测血清心肌肌钙蛋白T（cTnT）、C-反应蛋白（CRP）、肌酸激酶同工酶（CK-MB）和乳酸脱氢酶同工酶（LDH1）在不稳定型心绞痛（UA）患者中的变化，探讨各指标对UA的诊断价值。方法126例uA患者分别用生化分析仪检测cTnT、CK—MB和LDH1，特定蛋白分析仪检测CRP。结果cTnT升高23例（18．3％），CK—MB升高26例（20．6％），LDH1升高41例（32．5％），CRP升高73例（57．9％）。5个月内发生急性心肌梗死（AMI）16例，心源性猝死3例。其中上述各指标升高组AMI发生率明显高于正常对照组（P〈0．01）。多因素Logistic回归分析cTnT、LDH1、CRP升高、陈旧性心肌梗死和胸痛次数是预测近期AMI和心源性猝死的独立危险因素。结论cTnT、LDH1和CRP对UA患者的早期治疗和预后判断有重要临床意义，可作为UA患者的常规检测指标。

Relationship between unstable angina and cardiac troponin T and C-reactive protein

Objective To detect the levels of cardiac troponin T （cTnT）, C-reactive protein （CRP）, ereatine kinase isoenzyme（CK-MB） and lactate dehydrogenase isoenzymes（LDH1 ） in unstable angina （UA） patients and investigate their clinical value for the diagnosis of UA. Methods The levels of cTnT, CK-MB and LDH1 were detected with biochemical analyzer; CRP was detected with specific pro-tein analyzer. Results The elevated cases of cTnT, CK-MB, LDH1 and CRP were 23 cases（ 18.3% ） , 26 cases（20. 6% ）, 41 cases（32.5% ） and 73 cases（57.9% ）, respectively. Sixteen cases were at-tacked by acute myocardial infarction （AMI） and 3 cases suffered from sudden cardiac death in the five months. The incidence of AMI in the above elevated groups was significantly higher than that in the nor-mal control group （ P 〈0. 01 ）. The elevated levels of three index （cTnT, LDH1 and CRP）, old myo-cardial infarction and numbers of chest pain were independent risk factors by multivariate Logistic regres-sion analysis. Conclusions cTnT, LDH1 and CRP have important clinical significance for the early treatment and prognosis of patients with UA, which may be routine tests for these patients.