急性冠脉综合症患者血清CRP、BNP及D-二聚体水平变化及临床意义

目的研究急性冠脉综合症(ACS)患者血清C反应蛋白(CRP)、脑利尿钠肽(BNP)及D-二聚体(D-D)的水平变化及其意义。方法选择88例ACS患者为研究对象,按照病情程度不同分为心肌梗死(AMI)组(46例)和不稳定型心绞痛(UAP)组(42例);选择52例稳定型心绞痛患者(SAP组)及56例健康者(对照组)作为对照。检测不同组间血清CRP、BNP、D-D水平。结果四组间血清CRP、BNP、D-D水平比较,差异有显著统计学意义(p<0.001)。ACS患者血清CRP、BNP、D-D水平明显高于SAP组及对照组,差异有显著统计学意义(p<0.001)。而ACS患者中AMI组血清CRP、BNP、D-D水平明显高于UAP组,差异有显著统计学意义(p<0.001)。三组不同病变组组间血清CRP、BNP、D-D水平比较,差异有显著统计学意义(p<0.001)。ACS患者中多支组患者血清CRP、BNP、D-D水平明显高于双支组及单支组,差异有显著统计学意义(p<0.001)。而双支组患者血清CRP、BNP、D-D水平明显高于单支组,差异有显著统计学意义(p<0.001)。II组患者血清CRP、BNP、D-D水平明显高于I组,差异有显著统计学意义(p<0.001)。结论血清CRP、BNP、D-D水平与患者病情严重程度相关,血清CRP、BNP、D-D等指标可作为预测ACS病情程度及预后的检测指标。

LEVELS AND CLINICAL SIGNIFICANCE OF SERUM CRP,BNP AND D - DIMER IN PA- TIENTS WITH ACUTE CORONARY SYNDROME

Objective To study levels and clinical significance of serum CRP, BNP and D - dimer in ACS. Methods 88 ACS patients were selected as the research object, and were divided into myocardial infarction （AMI） group （46 cases） and UAP group （42 cases） according to the degree of illness. 52 patients with stable angi- na pectoris （SAP） and 56 cases of healthy subjects were selected as control group. Plasma CRP, BNP, D - D lev- els between different groups were detected. Results Serum CRP, BNP, D - D levels between the four groups were of statistically significant difference （p 〈0. 001 ） ; Serum CRP, BNP, D - D levels in ACS patients were obviously higher than those of SAP group and the control group, with statistically significant difference （p 〈 0. 001 ） ; Serum lev- els of CRP, BNP, D - D in ACS patients in AMI group, were significantly higher than those of UAP group, with significant difference （p 〈0. 001 ）. Serum CRP, BNP, D - D levels between 3 groups, had statistically significant difference （p 〈0. 001 ） ; Serum CRP, BNP, D - D levels of patients in group with more than two branehs were obvi- ously higher than that of double teams and single group, with statistically significant difference （p 〈0. 001 ） ; And se- rum CRP, BNP, D - D levels of patients in double branch group were obviously higher than that of single group, with significant difference （p 〈0. 001 ）. Serum CRP, BNP, D - D levels of patients in group II were significantly higher than the control group, with significant difference （p 〈0. 001 ）. Conclusion Serum CRP, BNP, D - D levels are associated with disease severity. Serum CRP, BNP, D - D indexes can be used as a testing index in ACS de- gree and prognosis.