C反应蛋白对不稳定型心绞痛危险分层的价值

目的：探讨C反应蛋白（CRP）对不稳定型心绞痛（UA）危险分层的临床价值。方法：对109例UA患者入院时分别测定CRP、心脏肌钙蛋白T（cTNT)、肌酸磷酸激酶同工酶（CK－MB），随访三个月，观察终点为急性心肌梗死（AMI）和心源性猝死。结果：在109例UA患者中，CRP升高37例（34.2%)，正常72例（66.1%)，三个月中发生急性心肌梗死10例，心源性猝死5例，冠状动脉成形术（PTCA）15例，冠脉搭桥术（CABG）6例。其中CRP升高组AMI的发生率明显高于正常组（P＜0.01)，但死亡率无明显差别。CRP的敏感度（83.33%)较TNT、CK－MB增高。多因素Logistic回归分析CRP升高、cTNT升高、陈旧性心梗和胸痛次数是预测近期AMI、心源性猝死的独立危险因素。结论：CRP对UA患者的近期预后和早期治疗有重要的临床价值，是危险分层的良好指标之一。

The value of C-reactive protein in the risk stratification of unstable angina

To evaluate the value of C-reactive protein (CRP) in the risk stratification in unstable angina. Methods: 109 patients with unstable angina were chosen and followed up 3 months. Everyone were measured with CRP,cTNT,CK-MB. The end point was cardiac events including acute infarction (AMI) and cardiac death. Results: In 109 patients with UA, 37 cases (34.2%) had elevated CRP level, 10 cases had AMI, 5 cases died of cardiac events. The rate of AMI was higher in patients with increased CRP (P< 0.01). But there was no difference between two groups in the death rate. The sensitivity of CRP for predicting cardiac events (83. 33% ) is greater than TNT and CK-MB and the specificity was 72.16% . Conclusions: CRP has practical significance in evaluating the short-term outcome and earlier treatment of unstable angina. It could be used as a marker for the risk stratification of UA.