急性冠脉综合征患者血清hs-CRP、Hcy和ET变化的临床研究

目的 探讨超敏C反应蛋白（hs-CRP）、同型半胱氨酸（Hcy）和内皮素（ET）在急性冠状动脉综合征（ACS）发生、发展中的意义.方法 选取行冠状动脉造影证实为ACS的患者78例,其中急性心肌梗死（AMI）患者20例,不稳定型心绞痛患者（UAP）30例,稳定型心绞痛（SAP）患者28例.同时选取健康体检者33例作为对照组.采用免疫散射比浊法检测患者血清中hs CRP水平,循环酶法测定Hcy,放射免疫法测定内皮素.结果 与对照组相比,ACS患者hs-CRP、Hcy、ET水平明显升高（P〈0.01）,其中AMI患者的hs-CRP水平明显高于SAP和UAP患者（P〈0.01）.随着冠状动脉病变的发展,由单支病变、双支病变到三支病变,hs-CRP、ET的水平也随之升高（P〈0.01）.结论 血清hs-CRP、Hcy、ET水平与ACS的发生、发展密切相关.

Clinical researches on changes of serum high-sensitivity C-reactive protein,homocysteine and endothelin in patients with acute coronary syndrome

Objective To investigate the significance of high-sensitivity C-reactive protein （hs-CRP）,homocysteine （Hcy） and endothelin（ET） in the occurrence and development of acute coronary syndrome（ACS）.Methods 78 cases with ACS confirmed by coronary arteriography were enrolled in this study,including 20 cases of acute myocardial infarction （AMI）,30 cases of unstable angina pectoris （UAP） and 28 cases of stable angina pectoris （SAP）.Another 33 cases of healthy volunteers were selected as the controls.The blood samples from ACS patients were collected within 2 h of ACS onset,and then hs-CRP,Hcy and ET level was detected by immune nephelometry,cyclophorase method and radio-immunoassay,respectively.Results The serum levels of hs-CRP,Hcy and ET in ACS patients increased significantly compared with those in the controls （P〈0.01） ,and hs-CRP level in AMI patients was significant higher than that in SAP or UAP patients（P〈0.01）.With the development of the coronary artery disease,from single to three vascular lesions,hs-CRP and ET levels increased accordingly （P〈0.01）.Conclusion The serum levels of hs-CRP,Hcy and ET appear to be closely correlated with the occurrence and development of ACS.