高敏C反应蛋白和心型脂肪酸结合蛋白对不稳定性心绞痛患者心脏意外事件的影响

目的探讨高敏 C 反应蛋白(hs-CRP)和心型脂肪酸结合蛋白(heart fatty acid bindingprotein,h-FABP)对不稳定性心绞痛(UAP)患者心脏意外事件的影响。方法将住院的心绞痛患者分成稳定性和不稳定性两组。其中,稳定性心绞痛(SAP)患者74例,男45例,女29例;UAP 患者56例,男29例,女27例。分别检测其血清 hs-CRP、h-FABP、心肌肌钙蛋白Ⅰ(cTn-I)和肌酸激酶-MB(CK-MB)的含量,并于2周内观察各组发生心脏意外事件的情况。并抽取同期门诊健康体检者50例作为对照组。结果 UAP 组的心脏意外事件发生率为26.8%,高于 SAP 组的10.53%(P<0.05);对照组无心脏意外事件发生。SAP 和 UAP 组患者血清 hs-CRP 的含量分别为(1.78±0.62)mg/L 和(7.64±2.18)mg/L,高于对照组的(0.59±0.27)mg/L(P<0.05,P<0.01);SAP 和 UAP 组血清h-FABP 的含量分别为(3.15±2.61)μg/L 和(16.46±5.28)μg/L,高于对照组的(1.83±0.75)μg/L(P<0.05,P<0.01);SAP 患者血清 cTn-I 的含量为(0.67±0.09)μg/L,与对照组(0.47±0.12)μg/L比较,差异无统计学意义(P>0.05)。UAP 组和 UAP 组中的Ⅲ级患者的血清 cTn-I 含量分别为(1.28±0.43)μg/L 和(2.14±1.49)μg/L,高于对照组的(0.47±0.12)μg/L(P<0.01)。而 UAP 组Ⅰ级和Ⅱ级患者其 cTn-1的含量为(0.53±0.13)μg/L 和(0.74±0.37)μg/L,与对照组比较差异无统计学意义;CK-MB 值各组间差异均无统计学意义。SAP 组中,发生心脏意外事件的患者其血清 hs-CRP 和 h-FABP 的含量分别为(6.32±2.06)μg/L 和(8.76±3.83)μg/L,高于对照组(P<0.01);UAP组中,发生心脏意外事件的患者其血清 hs-CRP、h-FABP 和 cTn-Ⅰ的含量分别为(9.82±3.15)μg/L、(22.21±8.87)μg/L和(2.68±0.48)μg/L,高于对照组(P<0.叭);另外,各组发生与未发生心脏意外事件的 CK-MB 值差异均无统计学意义。结论 hs-CRP、h-FABP 的联合检测较传统的心肌损伤检测指标 cTn-I 和 CK-MB 对 UAP 患者近期发生心脏意外事件的可能性具有更高的预测价值。

Serum high-sensitivity C-reaction protein and heart fatty acid binding protein level and cardiac accidents in patients with unstable angina pectoris

OBJECTIVE: To investigate the relationship between serum high-sensitivity C-reaction protein (hs-CRP) and heart fatty acid binding protein (h-FABP) on cardiac accidents in patients with unstable angina pectoris (UAP). METHOD: Serum levels of hs-CRP, h-FABP, cardiac troponin-I (cTn-I) and creatine kinase MB isoenzyme (CK-MB) were measured and cardiac accidents within 2 weeks after the test were observed in 74 patients (male 45) with stable AP (SAP) and 56 patients (male 29) with UAP. RESULTS: The incidence of cardiac accidents was significantly higher in UAP group (26.8%) than that in SAP group (10.53%, P < 0.001). Serum hs-CRP [(7.64 +/- 2.18) mg/L vs. (1.78 +/- 0.62) mg/L, P < 0.001], h-FABP [(16.46 +/- 5.28) microg/L vs. (3.15 +/- 2.61) microg/L, P < 0.001] and cTn-I [(1.28 +/- 0.43) microg/L vs. (0.67 +/- 0.09) microg/L, P < 0.001] levels were also significantly higher in UAP group than those in SAP group. The serum hs-CRP and h-FABP levels for patients with cardiac accidents in the SAP group were (6.32 +/- 2.06) microg/L and (8.76 +/- 3.83) microg/L respectively, which were higher than those for the patients having no cardiac accidents in the control (P < 0.01). The serum hs-CRP, h-FABP, cTn-I and CK-MB levels in patients with cardiac accidents were significantly higher than those in patients without cardiac accidents in both SAP and UAP groups. CONCLUSION: Measuring traditional parameters for myocardial damage (cTn-I and CK-MB) in combination with hs-CRP and h-FABP is valuable for predicting the risk of recent cardiac accidents for AP patients.