Cost effectiveness of influenza vaccination in patients with acute coronary syndrome in Korea

BackgroundInfluenza can cause cardiovascular abnormalities by inappropriately activating the coagulation cascade. Therefore, influenza vaccination is important because it decreases the risk of hospitalization for and mortality associated with heart disease. In particular, it reduces the occurrence of major adverse cardiovascular events (MACEs) in acute coronary syndrome (ACS) patients. Our study aimed to estimate the disease burden of MACEs and its related direct and indirect costs in ACS patients.MethodsWe estimated the direct and indirect cost of MACEs in ACS patients using a probabilistic model and the Health Insurance Review and Assessment (HIRA)-National Patient Sample (NPS) database. The effect of the influenza vaccination on the rate of MACE in ACS patients was determined using a previous systematic review and meta-analysis.ResultsOur study included 682,258 ACS patients obtained from the 2013 NPS database. According to our model, influenza vaccination would prevent 16,514 MACE-related hospitalizations and 2764 premature deaths in Korea per year. The overall reduction in costs would be $86.2 million per year from a societal perspective. Based on the results of sensitivity analysis, most of the estimated values were in the dominant area.ConclusionsOur findings show that influenza vaccination in ACS patients is highly cost effective in terms of lowering the cost of hospitalization and premature death due to MACE. Therefore, influenza vaccination is recommended as a means of relieving the clinical and socioeconomic burdens associated with ACS.     

Influenza vaccination reduces hospitalization for acute coronary syndrome in elderly patients with chronic obstructive pulmonary disease: A population-based cohort study

Background

Elderly patients with chronic obstructive pulmonary disease (COPD) are at a higher risk of hospitalization for cardiovascular complications, especially during respiratory infections. Previous studies showed that vaccination for influenza may reduce the risk of recurrent major cardiovascular events in patients with acute coronary syndrome (ACS). The purpose of this study was to evaluate the hypothesis that influenza vaccination could reduce hospitalizations for ACS in elderly patients with COPD.

Method

Using the Taiwan Longitudinal Health Insurance Database 1996–2008, this cohort study comprised elderly patients (≥55 years old) with a recorded diagnosis of COPD (n = 7722) between January 1, 2000 and December 31, 2007. Each patient was followed until the end of 2007. A propensity score was derived by using a logistic regression model to reduce vaccine therapy selection bias. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the occurrence of first hospitalization for ACS in elderly COPD patients was examined by Cox proportional hazards regression analysis. In addition, we categorized the patients into four groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2−3, and ≥4).

Results

We found that elderly patients with COPD receiving influenza vaccination had a lower risk of hospitalization for ACS (adjusted HR = 0.46, 95% CI (0.39–0.55), p < 0.001). We observed similar protective effects in both sexes and all age groups (55−64, 65−74, ≥75) regardless of influenza seasonality. When the patients were stratified according to the total number of vaccinations, the adjusted HRs for hospitalization because of ACS were 0.48 (0.38−0.62) and 0.20 (0.14−0.28) for patients who received 2−3 and ≥4 vaccinations during the follow-up period.

Conclusion

Our data showed that there was a lower risk of ACS hospitalization in elderly patients with COPD receiving annual influenza vaccination.     

Winter air pollution and infant bronchiolitis in Paris

Respiratory syncytial virus (RSV) is one of the most common respiratory pathogens in infants and young children. It is not known why some previously healthy infants, when in contact with RSV, develop bronchiolitis whereas others have only mild symptoms. Our study aimed to evaluate the possible association between emergency hospital visits for bronchiolitis and air pollution in the Paris region during four winter seasons. We included children under the age of 3 years who attended emergency room services for bronchiolitis (following standardized definition) during the period 1997-2001. Two series of data from 34 hospitals, the daily number of emergency hospital consultations (n=50857) and the daily number of hospitalizations (n=16588) for bronchiolitis, were analyzed using alternative statistical methods; these were the generalized additive model (GAM) and case-crossover models. After adjustments for public holidays, holidays and meteorological variables the case-crossover model showed that PM10, BS, SO2 and NO2 were positively associated with both consultations and hospitalizations. GAM models, adjusting for long-term trend, seasonality, holiday, public holiday, weekday and meteorological variables, gave similar results for SO2 and PM10. This study shows that air pollution may act as a trigger for the occurrence of acute severe bronchiolitis cases.     

北京市2008—2010年老年人流行性感冒疫苗接种情况及影响因素分析

流行性感冒(流感)已经多次引起世界范围大流行.2009年王小莉等[1]用蒙特卡罗模型对北京市甲型H1N1流感感染人数进行了估算,约有180万人感染.接种疫苗仍是预防流感最经济有效的措施[2].本研究对北京市老年人在2008-2010年流感流行前后流感疫苗接种的情况及影响2010年接种流感疫苗的因素进行了调查.     

Influenza vaccination among Saudi Hajj pilgrims: Revealing the uptake and vaccination barriers

BackgroundHajj is the world’s largest annual mass gathering that attracts two to three million Muslims from around the globe to a religious assemblage in Makkah, Saudi Arabia. The risk of acquisition and transmission of influenza among Hajj pilgrims is high. Therefore, influenza vaccination is recommended, and was monitored frequently among pilgrims from different countries. However, the vaccination uptake among Saudi pilgrims has not been assessed in recent years.ObjectiveThis analysis aims to evaluate influenza vaccine uptake among Saudi Hajj pilgrims, and identify the key barriers to vaccination.MethodData on influenza vaccination were obtained from Saudi pilgrims who took part in a large trial during the Hajj of 2013, 2014 and 2015. Pilgrims were met and recruited in Mina, Makkah during the peak period of Hajj and were asked to complete a baseline questionnaire that recorded their influenza vaccination history, including reason(s) for non-receipt of vaccine.ResultsA total of 6974 Saudi pilgrims aged between 18 and 95 (median 34) years were recruited; male to female ratio was 1:1.2. Of the total, 90.8% declared their influenza vaccination history, 51.3% of them reported receiving influenza vaccine before travel to Hajj. The vaccination rates for the years 2013, 2014 and 2015 were 21.4%, 48.2% and 58.1%, respectively (P < 0.001). Of 1,269 pilgrims who were at higher risk of severe disease, 54.5% received the vaccine. Lack of awareness (47.5%), reliance on natural immunity (15.8%) and being busy (15.5%) were the main reasons for non-receipt.ConclusionThese data from a convenience sample indicate that influenza vaccine uptake among Saudi Hajj pilgrims is increasing over years but still needs further improvement. Lack of awareness and misperceptions are the main barriers. Education of Saudi pilgrims and health professionals is required to raise awareness about influenza vaccination. Further studies are needed to understand pilgrims’ misperceptions.     

青岛市市南区1959～2000年病毒性肝炎流行特征分析

为全面了解病毒性肝炎的发病情况及其流行规律 ,为制订防制措施提供依据 ,现将青岛市市南区 4 2年来的病毒性肝炎疫情资料分析如下。1.流行概况 :本区自 195 9年有疫情记载以来至 2 0 0 0年病毒性肝炎累计发病 2 170 2例 ,死亡 11例 ,病死率为 0 .0 5 %。4 2年平均发病率为 196 .86 / 10万 ,发病率波动在 2 7.0 2 /10万～ 6 5 2 .94 / 10万 ,其中 196 0年发病率最高 ,为 6 5 2 .94 /10万 ;2 0 0 0年最低 ,为 2 7.0 2 / 10万 ,进入 1989年以来未发生死亡病例。肝炎发病位次由 2 0世纪 70年代至 90年代初的第 2位 ,逐步下降至 1999～ 2 0 0 0…     

Influenza vaccination hesitancy and its determinants among elderly in China: A national cross-sectional study

BackgroundThe Chinese elderly face a significant threat from seasonal influenza, owing to the consistently low vaccination coverage. This study investigated the prevalence and determinants of influenza vaccination hesitancy among the Chinese elderly.MethodsIn 2019, 3849 elderly individuals from 10 provinces in China were recruited in a cross-sectional survey. Multinomial logistic regression was applied to investigate the determinants of influenza vaccination hesitancy.ResultsAmong the elderly respondents, 37.18% expressed some degree of hesitancy towards influenza vaccination: 19.28% were hesitant, and 17.90% refused influenza vaccination, including 19.28% acceptors with doubts and 17.90% refusers. Only 39.10% of the respondents considered themselves as the priority group for influenza vaccination, and 13.93% reported receiving a recommendation for vaccination from healthcare workers. Respondents with higher education levels and from urban areas had significantly higher odds of vaccine hesitancy than their counterparts. Confidence in the safety of vaccines was negatively associated with vaccine hesitancy, but confidence in vaccine efficacy had no such association. Respondents who perceived themselves as highly susceptible to influenza (AOR = 0.85; 95 %CI = 0.77–0.93) and those aware of the elderly as a priority group for influenza vaccination (AOR = 0.51; 95 %CI = 0.41–0.64) had a significantly lower odds of being refusers.ConclusionThis study found a high prevalence of hesitancy towards influenza vaccination among the Chinese elderly, especially well-educated and urban-dwelling respondents. The government should address vaccine hesitancy through culturally appropriate communication, subsidies for vaccination, and actively promoting vaccines through primary care professionals.     

老年急性冠脉综合征23例临床分析

目的 提高急性冠脉综合征(ACS)抢救成功率。方法 将某部队2001年师以上离退休干部年龄在60岁以上患急性冠脉综合征23例门诊急诊就医及转归情况进行分析。结果不稳定心绞痛(UAP)20例，急性心肌梗死(AMI)3例，其中再梗死1例。经皮腔内冠脉成形术(PTCA) 支架植入术3例，支架植入术后冠状动脉搭桥术1例，冠状动脉搭桥术4例。结论 认识缺血性胸痛，及时诊断，早期处理是提高ACS抢救成功率的关键。     

Influenza vaccination and risk of hospitalization among adults with laboratory confirmed influenza illness

Background

Influenza vaccine is moderately effective for preventing influenza illness. It is not known if vaccination reduces the risk of subsequent hospital admission among patients with vaccine failure and laboratory confirmed influenza illness.

Methods

Patients in a community cohort presenting with acute respiratory illness were prospectively enrolled and tested for influenza during 8 seasons to estimate seasonal vaccine effectiveness. Hospital admissions within 14 days after illness onset were identified for all participants aged ≥20 years with laboratory confirmed influenza. The association between vaccination and hospital admission was examined in a propensity score adjusted logistic regression model. The model was validated by examining the association between vaccination and hospital admission in participants without influenza.

Results

Influenza was identified in 1393 (28%) of 4996 participants. Sixty-two (6%) of 1020 with influenza A and 17 (5%) of 369 with influenza B were hospitalized. Vaccination was not associated with a reduced risk of hospital admission among all participants with influenza [adjusted odds ratio (aOR) = 1.08; 95% CI: 0.62, 1.88]; or among those with influenza A (aOR = 1.35; 95% CI: 0.71, 2.57) or influenza B (aOR = 0.67; 95% CI: 0.21, 2.15). Influenza vaccination was not associated with hospitalization after non-influenza respiratory illness (aOR = 1.14; 95% CI: 0.84, 1.54).

Conclusions

Influenza vaccination did not reduce the risk of subsequent hospital admission among patients with vaccine failure. These findings do not support the hypothesis that vaccination mitigates influenza illness severity.     

老年高危急性冠脉综合症介入治疗远期疗效观察

目的探讨介入治疗在老年高危冠脉综合征患者中的远期疗效。方法选取2005年1月～2009年8月在某院检查诊断为冠脉综合征的患者中的140例老年高危ACS患者作为观察对象,其中根据患者意愿及病情进行介入治疗者70例(介入治疗组),根据研究对象可比性原则选取常规药物保守治疗患者70例(保守治疗组)作为对照组,进行观察两组患者远期治疗效果。结果两组患者MACE发生率、猝死率、术后严重出血发生率随着时间延长发生几率逐渐增高,术后半年、1年保守治疗组患者各项指标发生率稍高于介入治疗组患者,但各项观察指标之间差异无统计学意义(P﹥0.05);术后2年,保守治疗组死亡率高于术后严重出血量低于介入治疗组,两组之间差异有统计学意义(P﹤0.05)。结论高危老年急性冠脉综合征患者早期及时进行介入治疗可以有效的降低MACE发生率,提高患者生存率,术后抗凝药物的使用要个性化并且控制好剂量,以防出现严重出血。     

心电图与冠状动脉造影诊断急性冠状动脉综合征相关病变血管的对比研究

目的 观察急性冠状动脉综合征（ACS）患者心电图（ECG）与冠状动脉造影（CAG）结果的关系。方法 对107例由急诊科收入院的ACS患者的ECG及CAG结果进行分析。结果（1）不稳定型心绞痛及非sT段抬高的急性心肌梗死患者血管病变情况复杂，单支、2支、3支病变均占一定比例；急性前壁心肌梗死单支病变以左前降支病变为主，2支以上病变均包含左前降支病变；急性下壁心肌梗死单支病变以右冠状动脉病变为主，2支以上病变均包含右冠状动脉病变。（2）ST段抬高的急性心肌梗死与非ST段抬高的急性心肌梗死单支病变发病率差异无统计学意义（36％vs28％，P〉0．05），2支以上病变发病率差异也无统计学意义（64％vs63％，P〉0．05）。（3）〈65岁组单支病变发病率明显高于≥65岁组（46％vs18％，P〈0．01），〈65岁组2支以上病变发病率明显低于≥65岁组（48％vs78％，P〈0．01）。（4）ECG诊断ACS相关病变血管的特异度为100．0％，敏感度为33．3％。结论 ST段抬高的急性心肌梗死患者ECG能基本确定相关病变血管，而非ST段抬高的急性心肌梗死及不稳定型心绞痛患者ECG不易确定相关病变血管，应尽早行CAG检查明确诊断；年龄越大，患者冠状动脉病变情况越复杂，亦应尽早行CAG检查。     

心电图与冠状动脉造影诊断急性冠状动脉综合征相关病变血管的对比研究

目的观察急性冠状动脉综合征(ACS)患者心电图(ECG)与冠状动脉造影(CAG)结果的关系。方法对107例由急诊科收入院的ACS患者的ECG及CAG结果进行分析。结果(1)不稳定型心绞痛及非ST段抬高的急性心肌梗死患者血管病变情况复杂,单支、2支、3支病变均占一定比例;急性前壁心肌梗死单支病变以左前降支病变为主,2支以上病变均包含左前降支病变;急性下壁心肌梗死单支病变以右冠状动脉病变为主,2支以上病变均包含右冠状动脉病变。(2)ST段抬高的急性心肌梗死与非ST段抬高的急性心肌梗死单支病变发病率差异无统计学意义(36%vs28%,P>0.05),2支以上病变发病率差异也无统计学意义(64%vs63%,P>0.05)。(3)<65岁组单支病变发病率明显高于≥65岁组(46%vs18%,P<0.01),<65岁组2支以上病变发病率明显低于≥65岁组(48%vs78%,P<0.01)。(4)ECG诊断ACS相关病变血管的特异度为100.0%,敏感度为33.3%。结论ST段抬高的急性心肌梗死患者ECG能基本确定相关病变血管,而非ST段抬高的急性心肌梗死及不稳定型心绞痛患者ECG不易确定相关病变血管,应尽早行CAG检查明确诊断;年龄越大,患者冠状动脉病变情况越复杂,亦应尽早行CAG检查。     

急性冠脉综合症的炎症反应与治疗

炎症反应是急性冠脉综合症（简称ACS）病理生理机制的一个中心环节，炎症导致ACS的途径之一是炎症刺激了斑块的破裂，从而导致血栓的形成。其中感染因素及非感染因素均具有致炎作用。关于直接应用抗生素预防ACS的疗效尚不确切，有待于更完善的实验去证实；他汀具有明显的抗炎作用，且这种抗炎作用并不依赖于血脂的调节。本文对ACS的炎症反应与治疗作更进一步的综述。     

Factors associated with influenza vaccination among elderly Spanish women

OBJECTIVES: Influenza vaccination is an effective intervention to diminish morbidity and mortality associated with this disease in aged populations and at-risk groups. The objective of this work was to describe population patterns of vaccination among Galician women and to identify factors associated with vaccination. STUDY DESIGN: Cross-sectional study. METHODS: Cases aged 65 years and over were selected from the Women's Social and Health Interview, Galicia 2000 (n = 1111). The association between influenza vaccination last season and several sociodemographic, lifestyle, health status and health services variables was assessed by logistic regression. RESULTS: In total, 56.3% of cases had received the influenza vaccine. The following variables were significantly associated with vaccination: age 70-74 years (odds ratios, OR=1.56; 95% CI: 1.09-2.26); age> or =75 years (OR=1.88; 95% CI: 1.31-2.71); residence in towns with 5000-20,000 inhabitants (OR=1.79; 95% CI: 1.16-2.77); annual income 6.010 (OR=1.39; 95% CI: 1.01-1.90); unfavourable self-perception of health (OR=1.46; 95% CI: 1.06-2.00); not being a caregiver (OR=1.67; 95% CI: 1.17-2.38); married (OR=1.45; 95% CI: 1.05-2.01); tetanus vaccination (OR=1.43; 95% CI: 1.07-1.93); and visiting a physician in the last 2 years (OR=4.83; 95% CI: 2.61-8.93). CONCLUSIONS: The level of vaccination among Galician women is low, although it is higher than that in Spanish women overall. This work has identified groups of women who are less likely to be vaccinated, and who should be targeted in future vaccination campaigns.     

心肺运动试验在老年急性冠状动脉综合征患者心脏康复的应用

目的 回顾性分析老年(≥65岁)冠心病患者心肺运动试验(CPET)的相关数据,探讨老年急性冠状动脉综合征(ACS)患者CPET的临床特点。方法 选取2015年4月~2016年4月在沈阳军区总医院心内科住院诊断冠心病并进行CPET测试的老年(≥65岁)患者共356例,均使用Schiller CS-200心肺运动试验系统进行测试,在静息状态下测定人体的肺功能、心电图,继之连续动态监测记录进出气流、O_2浓度、CO_2浓度、全导联心电图、血压和血氧饱和度的实时变化。结果 ACS组与稳定型冠心病(SCHD)组比较,在年龄、性别比例、体质量指数(BMI)及吸烟、高血压、糖尿病、高脂血症等方面差异无统计学意义,但陈旧心肌梗死发生率ACS组高于SCHD组(31.8%vs 6.4%,P0.05),ACS组左室射血分数(LVEF)值低于SCHD组[(52.6±4.3)vs(56.9±5.1),P0.05]。ACS组危险分层中高危患者比例、运动终止Borg评分高于SCHD组[43.5%vs 5.9%,(16.0±1.4)vs(15.5±1.3),P0.001],而运动持续时间[(7.32±0.68)min vs(9.09±0.93)min,P0.001]低于SCHD组。不论ACS组还是SCHD组,无氧阈(AT)负荷及峰值负荷均明显降低,ACS组AT摄氧量、AT公斤摄氧量、AT负荷(Mets)、呼吸频率、呼吸储备、FVC%和FEV1%均低于SCHD组(P0.001)。结论 老年ACS患者因心功能较差、高危患者比例较高,导致在CPET中运动持续时间缩短、运动耐量明显下降,呼吸储备和呼吸功能也明显下降,需高度重视。     

基于倾向得分匹配的老年人接种流感疫苗对流感就诊的保护效果研究

目的 评估老年人接种流感疫苗对流感就诊的保护效果,并探讨倾向得分匹配法（PSM）在疫苗保护效果研究中的应用价值。方法 以成都市为研究现场,选取2017年9-12月间接种流感疫苗的60岁及以上老年人作为接种组,采用PSM法选取观察对象作为对照组。匹配后比较两组人群疫苗接种后一年内的流感就诊情况,评价疫苗保护效果。结果 流感疫苗接种组与未接种组各有1442例匹配成功。两组的一般人口学特征、生活方式及健康意识、基本健康状况等特征在匹配前有显著差异,匹配后两组协变量达到均衡。匹配后接种组和对照组流感就诊率分别为0.69%、2.84%,疫苗接种可减少之后一年内75.70%的流感就诊。结论 PSM可有效降低观察性研究组间的混杂偏倚,在疫苗接种效果评价中具有长远的应用价值。流感疫苗接种对降低≥60岁老年人流感就诊具有良好效果,今后有必要采取措施提高流感疫苗接种率。     

急性冠状动脉综合征合并低T3综合征的临床特点分析

目的 探讨急性冠状动脉综合征(ACS)合并低T3综合征的临床特点及其与预后的相关性.方法 选择ACS合并低游离三碘甲腺原氨酸(FT3)水平的住院患者87例(低FT3组),另外选择64例FT3水平正常的ACS患者作为对照组,均行冠状动脉造影检查.抽取患者空腹静脉血检测FT3、N-末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白Ⅰ(cTnI)、超敏C反应蛋白(hs-CRP)水平;记录两组单支病变、2支病变与多支病变的患者数量.结果 与对照组比较,低FT3组NT-proBNP、cTnI及hs-CRP均显著升高[(1242.14±226.32) ng/L比(1126.36±195.55) ng/L,(0.92±0.23) ng/L比(0.84±0.19) ng/L,(6.46±2.25) mg/L 比(5.71±1.78) mg/L](P＜ 0.01或＜0.05).两组FT3水平均与NT-proBNP、cTnI及hs-CRP呈显著负相关(P＜0.05).两组冠状动脉病变数量比较差异无统计学意义(x2=4.512,P=0.105).结论 ACS患者血清FT3水平与病情的严重程度有良好相关性,与冠状动脉病变数量无明显相关性,对预后有一定预测价值.     

急性冠脉综合征患者血清和肽素浓度的改变

目的 观察临床急性冠脉综合征(ACS)病人血清和肽素浓度的变化,并探讨其临床意义.方法 入选临床观察对象86例,其中包括不稳定型心绞痛组(UAP组)31例,急性心肌梗死(AMI组)25例,另外以正常健康人30例为正常对照组.所有入选者均测定血压(BP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高敏C-反应蛋白(hs-CRP)和血清和肽素浓度.结果 ①与正常对照组比较,UAP组和AMI组的BP、TG、TC、LDL-C、hs-CRP和血清和肽素浓度均显著升高.②与UAP组比较,AMI组BP、TG、TC、LDL-C无明显差异,但是血清hsCRP、和肽素浓度均明显升高(P＜0.05).③ACS患者的血清和肽素浓度与hs-CRP定量有明显的正相关性(r=0.296,P＜ 0.05).结论 ACS患者血清和肽素浓度显著升高,并与病情的严重程度和炎症反应相关,可以作为ACS的重要实验室观察指标.     

The risk of dying on days of higher air pollution among the socially disadvantaged elderly

Rationale

The estimated mortality rate associated with ambient air pollution based on general population studies may not be applicable to certain subgroups.

Objective

The objective of the present study was to determine the influence of age, education, employment status and income on the risk of mortality associated with ambient air pollution.

Methods

Daily time-series analyses tested the association between daily air pollution and daily mortality in seven Chilean urban centers during the period January 1997–December 2007. Results were adjusted for long-term trends, day-of-the week and humidex.

Results

Interquartile increases in particulate matter (PM₁₀ and PM_2.5), sulphur dioxide, nitrogen dioxide, carbon monoxide, and elemental and organic carbon were associated with a 4–7% increase in mortality among those who did not complete primary school (p<0.05) vs. 0.5–1.5% among university graduates (p>0.05). Among those at least 85 years of age respective estimates were 2–7%. However, among the elderly who did not complete primary school, respective estimates were 11–19% (p<0.05). The degree of effect modification was less for income and employment status than education, and sex did not modify the results.

Conclusion

The socially disadvantaged, especially if elderly appear to be especially susceptible to dying on days of higher air pollution. Concentrations deemed acceptable for the general population would not appear to protect this susceptible subgroup.     

依诺肝素对急性冠脉综合征患者血清抵抗素浓度的影响

目的研究依诺肝素对急性冠脉综合征(acute coronary syndrome,ACS)患者血清抵抗素浓度的影响。方法选取2010年3月—2011年6月行冠状动脉造影的ACS患者93例,分为不稳定型心绞痛(unstable angina,UA)组34例、非ST段心肌梗死(non ST-segment elevation myocardial infarction,NSTEMI)组30例、ST段抬高性心肌梗死(ST-segment elevation myocardial infarction,STEMI)组29例,选择同期健康人30名作为对照组。所有患者给予依诺肝素皮下注射,收集治疗前后患者血液,经ELISA法测定血清抵抗素浓度,并进行组间比较。结果治疗后UA组、NSTEMI组、STEMI组血清抵抗素浓度分别为(8.15±1.18)、(15.21±12.03)、(15.08±2.20)μ/L,与治疗前比较,差异均有统计学意义,但仍均高于对照组(均P0.05)。结论依诺肝素能显著降低ACS患者血清抵抗素浓度,抑制炎症反应,可减轻动脉粥样硬化。