急性冠脉综合征预后与其支架术前CRP、Fib、D-二聚体水平的关系

目的:探讨急性冠脉综合征(ACS)预后与其支架术前C反应蛋白(CRP)、纤维蛋白原(Fib)、D-二聚体水平的关系。方法:分别选择110例健康体检者(健康对照组)和110例接受冠脉支架术治疗的ACS患者(ACS组),测定两组患者CRP、Fib和D-二聚体的水平。6个月后对ACS组患者进行心血管事件评定,根据是否发生心血管事件分为事件组(35例)和非事件组两组(75例)。结果:与健康对照组比较,ACS组患者CRP(2.02±1.17)mg/L比(11.15±3.12)mg/L]、Fib(2.65±1.07)g/L比(4.03±1.19)g/L]、D-二聚体(193.97±18.13)μg/L比(632.15±21.72)μg/L]的水平明显升高(P<0.05);与非事件组患者比较,事件组CRP(9.69±3.14)mg/L比(14.28±3.32)mg/L]、Fib(3.88±1.09)g/L比(4.36±1.23)g/L]、D-二聚体(509.13±21.57)μg/L比(895.77±25.03)μg/L]的水平明显升高(P<0.05),直线相关分析显示,事件组患者CRP与Fib(r=0.41,P<0.05)、D-二聚体(r=0.54,P<0.01)水平呈正相关,Fib与D-二聚体亦呈正相关(r=0.39,P<0.05)。结论:急性冠脉综合征患者C反应蛋白、纤维蛋白原和D-二聚体的水平较健康体检者升高,急性冠脉综合征支架术前C反应蛋白、纤维蛋白原、D-二聚体水平越高,其预后越差。

Relationship among levels of CRP, Fib, D-dimer before stenting and prognosis of acute coronary syn- drome

Objective： To study relationship among levels of C-reactive protein （CRP）, fibrinogen （Fib）, D-dimer before stenting and prognosis of acute coronary syndrome （ACS）. Methods： A total of 110 healthy subjects （healthy control group） and 110 ACS patients undergoing stenting （ACS group） were enrolled. Levels of CRP, Fib and D-di- mer were measured in two groups. Cardiovascular event was assessed in ACS group after six months, and according to occurrence of cardiovascular events or not, ACS group was divided into event group （n = 35） and no event group （n = 75）. Results： Compared with healthy control group, there were significant increase in levels of CRP （2.02 ± 1.17） mg/Lvs. （11.15±3.12） mg/L], Fib （2.65±1.07） g/Lvs. （4.03±1.19） g/L] andD-dimer （193.97± 18. 13） μg/L vs. （632.15± 21.72） μg/L] in ACS group, P〈0.05 all;compared with no event group, there were significant increase in levels of CRP （9.69 ±3.14） mg/L vs. （14.28±3.32） mg/L], Fib （3.88± 1.09） g/L vs. （4. 36 ± 1.23） g/L] and D-dimer （509.13± 21.57） μg/L vs. （895.77 ± 25.03） μg/L] in event group, P〈0.05 all. In event group, rectilinear correlation analysis indicated that CRP was positively correlated with levels of Fib （ r = 0.41, P〈0.05） and D-dimer （r = 0.54, P〈0.01）, and Fib was also positively correlated with D-dimer （r =0.39, P〈0.05）. Conclusion.. Compared with healthy controls, there are significant increases in levels of CRP, Fib and D-dimer in ACS patients. The higher levels of these indexes are before stenting, the poorer prognosis is in patients with acute coronary syndrome.