高敏C反应蛋白在急性冠脉综合征中的临床意义

目的探讨高敏C反应蛋白(highsensitive c-reactive protein,hs-CRP)在急性冠脉综合症患者中的改变以及在急性心肌梗死患者中随发病时间的变化趋势。方法采用免疫比浊法对126例急性心肌梗死患者和135例不稳定型心绞痛患者进行hs-CRP检测,并按照常规方法测定白细胞、中性粒细胞及血脂水平。同时对22例急性心肌梗死患者进行发病12h之内、24h、48h、72h时和7d的hs-CRP检测,进行两两比较。结果急性心肌梗死组hs-CRP水平(6.26±5.60mg/L),明显高于不稳定型心绞痛对照组(3.52±4.34mg/L),2组间差异有统计学意义(P=0.000)。2组间的白细胞和中性粒细胞差异有统计学意义,而总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和三酰甘油2组间差异无统计学意义(P>0.05)。22例急性心肌梗死患者发病48h(13.05±3.89)mg/L或72h(13.04±3.98)mg/L的hs-CRP水平较发病12h内(5.34±5.45)mg/L明显增高。结论hs-CRP在急性心肌梗死患者比不稳定型心绞痛患者明显增高。急性心肌梗死发病48h或72h的hs-CRP较发病12h内更能反映急性冠脉事件的严重程度。

The Clinical Significance of High Sensitive C-reactive Protein in Patients with Acute Coronary Syndrome

Objective To explore the changes of high sensitive c-reactive protein(hs-CRP) in patients with acute coronary syndrome(ACS) and the variation tendency of hs-CRP in acute myocardial infraction(AMI) patients. Methods The single-centre study enrolled 126 acute myocardial infraction(AMI) patients and 135 unstable angina(UA) patients. The serum hs-CRP were measured by immune nephelometry. Leucocyte neutrophilic granulocyte and serum lipids(TC, LDL-C, HDL-C and TG) were also be measured. In 22 AMI patients, hs-CRP was measured at within 12 h, 24 h, 48 h, 72 h and 7 d. Results The levels of hs-CRP in patients with AMI(6.26±5.60 mg/ L ) were significantly higher than those in UA patients(3.52±4.34 mg/L)(P=0.000). The levels of leucocyte and neutrophilic granulocyte in AMI group were significantly higher than those in UA patients. There was no significant difference of the serum lipids(TC, LDL-C, HDL-C and TG) between the two groups(P>0.05). The levels of hs-CRP at 48 h or 72 h in AMI patients were significantly higher than those within 12 h. Conclusion The levels of hs-CRP in AMI patients are higher than those in UA patients. The levels of hs-CRP at 48 h or 72 h in AMI patients are superior to those within 12 h in reflecting the severity of AMI.