老年急性冠脉综合征患者心肌损伤标志物水平与疾病危险程度的相关性

目的:探讨老年急性冠脉综合征(ACS)患者血清超敏C反应蛋白(hs-CRP)、生长分化因子(GDF-15)、心型脂肪酸结合蛋白(H-FABP)及缺血修饰白蛋白(IMA)水平变化及其与ACS危险分层的相关性.方法:将68例老年ACS患者作为疾病组,采用GRACE评分法进行危险分层,根据评分结果将疾病组患者分为低危组(23例)、中危组(25例)及高危组(20例);另选同期体检健康者60例作为对照组.比较各组间血清hs-CRP、GDF-15、H-FABP及IMA水平差异及相关性.结果:与对照组比,疾病组患者血清hs-CRP、GDF-15、H-FABP及IMA水平均明显较高.不同危险分层组间:中、高危组患者血清hs-CRP水平均明显高于低危组,而中、高危组间比较,hs-CRP水平无明显差异;血清GDF-15、H-FABP及IMA水平变化趋势均为低危组<中危组<高危组.老年ACS患者血清GDF-15、H-FABP及IMA水平均与hs-CRP水平呈正相关.结论:血清中心肌损伤指标GDF-15、H-FABP及IMA水平均与老年ACS患者疾病危险程度呈正相关,对老年ACS的危险分层具有较高的参考价值.

Correlation of serum myocardial injure markers in the elder acute coronary syndrome patients with the disease risk stratification

Objective To detect the serum levels of hypersensitive C-reactive protein (hs-CRP), growth differentiation factor-15(GDF-15), heart fatty acid binding protein (H-FABP) and ischemia modified albumin (IMA) in the elder patients with acute coronary syndrome (ACS), and explore the level changes of those myocardial injure markers and the correlation of them with the ACS risk stratification.Methods 68 cases of elder patients with ACS were selected as the disease group, and the risk stratifi-cation of ACS were evaluated by Global Registry of Acute Coronary Events (GRACE) risk score. Then the patients were continue divided into the low risk group (with23 cases), the medium risk group (with25 cases) and the high risk group (with20 cases), ac-cording to the GRACE risk score.60 healthy people in the same period with the ACS patients were selected as the healthy control group. The levels of hs-CRP, GDF-15, H-FABP and IMA among the groups were compared. Finally, the correlation of GDF-15, H-FABP and IMA with hs-CRP were analyzed.Results Compared with the control group, the levels of hs-CRP, GDF-15, H-FABP and IMA in the disease group were all significantly higher. The levels of hs-CRP in the high risk group and the medium risk group were obviously higher than that in the low risk group. But no significant difference of it was found between the high risk group and the medium risk group. The levels of GDF-15, H-FABP and IMA in the high risk group were significantly higher than that in the medium risk group and the low risk group. And the medium risk group had higher levels of GDF-15, H-FABP and IMA than the low risk group. The levels of GDF-15, H-FABP and IMA were all showed the positive correlation with hs-CRP. Conclusions The levels of serum myocardial injure markers about GDF-15, H-FABP and IMA were showed the positive corre-lation with the risk of elder ACS, and they have high reference value for the risk stratification of elder ACS.