血肌钙蛋白Ⅰ、C-反应蛋白和D-二聚体水平与急性胸痛患者预后关系的评价

目的：前瞻性研究血清肌钙蛋白Ｉ（ｃＴｎＩ）、Ｃ－反应蛋白（ＣＲＰ）和血浆Ｄ－二聚体水平对急性胸痛患预后的评估作用。方法：９０例急性胸痛患，分别测定ｃＴｎＩ、ＣＲＰ和Ｄ－二聚体水平后，随诊３个月。随诊终点为心脏事件。结果：随诊期间１４例患发生心脏事件，其中８６％患ｃＴｎＩ水平升高，５０％ＣＲＰ升高，７９％Ｄ－二聚体升高，５０％患３项均升高。９０例患中，ｃＴｎＩ升高和正常组心脏事件发生率分别为２５％和５％（Ｐ〈０．０１），ＣＲＰ升高和正常组为３２％和１０％（Ｐ〈０．０１），Ｄ－二聚体升高和正常组为３３％和５％（Ｐ〈０．００１）。结论：急性胸痛患就诊时的ｃＴｎＩ、ＣＲＰ和Ｄ－二聚体水平分别与预后相关。

Prognostic value of levels of serum troponin I and C-reactive protein and plasma D-dimer on patients with acute chest pain

Objective To prospectively evaluate the prognostic influence of serum cardiac troponin I (cTnI), C reactive protein (CRP) and plasma D dimer levels on patients with acute chest pain. Methods 90 patients were studied. Levels of serum cTnI, CRP and plasma D dimer were determined 24 hours after hospitalization. Then the patients were followed up for 3 months. The end point was cardiac events which included myocardial infarction, cardiac death and emergent intervention or bypass grafty. Results 14 patients developed cardiac events and 86% had elevated cTnI level, 50% had elevated CRP, 79% had elevated D dimer. For the 90 patients the events were more frequent in those with elevated cTnI (25%vs 5%, P< 0 01), CRP (32% vs 10%, P < 0 01) or D dimer (33% vs 5%, P < 0 001) levels respectively. Conclusion The levels of cTnI, CRP or D dimer of patients with acute chest pain are related with prognosis respectively.