急性冠脉综合征患者缺血修饰性白蛋白、hs-CRP及NT-proBNP的动态变化

目的探讨急性冠脉综合征(ACS)患者缺血修饰性白蛋白(IMA)、超敏C反应蛋白(hs-CRP)及氨基末端B型利钠肽原(NT-proBNP)24 h的动态变化。方法选择56例ACS患者,分别在就诊时(3 h组)、胸痛6 h时(6 h组)和24 h时(24 h组)抽血检测IMA、hs-CRP和NT-proBNP水平,与40例健康体检者(对照组)进行比较。结果3 h组、6 h组和24 h组IMA水平无显著性差异,而hs-CRP和NT-proBNP呈显著性升高;ACS患者3 h组血清IMA、hs-CRP水平显著高于对照组(P均<0.01);而NT-proBNP与对照组比较无显著性差异;3 h组、6 h组和24 h组组间IMA阳性率无显著性差异,但均显著高于对照组阳性率及相应时段的hs-CRP和NT-proBNP阳性率。结论ACS患者可能同时存在缺血、炎症和心功能受损的连贯改变。IMA是反映ACS心肌缺血的一个非常早的灵敏指标,对于发病<3 h的ACS更有价值。

Dynamic changes of ischemia modified albumin, hs-CRP and NT-proBNP in patients with acute coronary syndrome

Objective It is to discuss the dynamic changes of ischemia modified albumin(IMA),hs-CRP and NT-proBNP within 24h in patients with acute coronary syndromes(ACS).Methods 56 patients with ACS were chosen and their blood were gotten by intravenous haemospasia to determine the levels of serum IMA,hs-CRP and NT-proBNP at visiting(3 h group) and 6 and 24 hours after chest pain occurred(6 h group and 24 h group).Then the determining results were compared with that of 40 healthy people(control group).Results There was no significant difference in IMA in the three groups of ACS,but hs-CRP and NT-proBNP increased obviously.The levels of serum hs-CRP and NT-proBN in 3 h group were obviously higher than those in the control group(all P<0.01),but there was no significant difference in NT-proBNP between 3 h group and control group.There was no significant difference in IMA positive rate among the three groups of ACS,but the rate was obviously higher than that in control group and the positive rates of hs-CRP and NT-proBNP in the corresponding time.Conclusion Pathologic changes such as ischemia,inflammation and heart function injury may exist together in patients with ACS.IMA is an early sensitive indicator which can indicate early myocardial ischemia in ACS,and it has more value for the diagnosis of ACS which occurs in 3 hours.