P-选择素、C-反应蛋白和心肌肌钙蛋白I对急性冠状动脉综合征的预后价值  

Prognostic values of P-selectin,C-reactive protein and cardiac troponin I in patients with acute coronary syndrome.

作　　者：陈以初[1] 廖树森[2] 石光忠[2] 米红[2] 刘薇薇[2] 

机构地区：[1]广东省东莞市厚街医院内科,523960 [2]广西壮族自治区北海市人民医院心内科

出　　处：《中国综合临床》2006年第12期1077-1079,共3页Clinical Medicine of China

摘　　要：目的探讨P-选择素、C-反应蛋白(CRP)和心肌肌钙蛋白I(cTnI)对急性冠状动脉综合征(ACS)患者短期预后评估的作用。方法分别测定70例ACS患者入院时外周血的P-选择素、CRP和cTnI水平。随诊1个月,终点为心脏事件。同时测定18例健康成人的P-选择素作对照。结果ACS组的P-选择素水平较对照组明显增高(P<0.01),在70例ACS患者中P-选择素升高27例,CPR升高23例,cTnI升高38例。随诊期共发生心脏事件14例,各因子增高组的心脏事件率均较正常组高(均为P<0.05)。其与ACS预后关系的相对危险度分别是5.74、6.83和3.94(均为P<0.05)。阳性预测值分别是37%、34%和28%。这三种因子的联合试验对心脏事件的阳性预测值是42.9%。结论P-选择素与ACS发生有关;P-选择素、CRP和cTnI分别与ACS短期预后有关,可作为危险分层的指标之一;联合检测意义更大。Objective To evaluate the prognostic values of P-selectin, C-reactive protein（CRP） and cardiac troponin Ⅰ（cTnⅠ）in patients with acute coronary syndrome （ACS）. Methods The levels of P-selectin, CRP and cTnl in 70 patients with ACS were determined after hospitalization. Then the patients were followed up for a month. The end-point was cardiac events. Meanwhile,the levels of P-selectin of 18 healthy adults were measured as control group. Results The level of P-selectin was significantly higher in ACS group than in control group （ P 〈 0.01 ）. Among 70 patients with ACS,27 cases had elevated P-selcctin,23 had elevated CRP, and 38 had elevated cTnⅠ. 14 patients developed cardiac events. All the rates of cardiac events in each factor elevated group were higher than those in controls （ P 〈 0.05 ）. The relative risk factor for the cardiac events according to the elevated P-selectin, CPR and cTnⅠ were 5.74,6.83 and 3.94, respectively （ P 〈 0.05 for each ）. Accordingly, the positive predictive values of these factors for the cardiac events were 37% ,34% and 28% ,respectively. The positive predictive value of serial test of three factors to cardiac events was 42.9%. Conclusion P-selectin is associated with the pathogenesis of ACS; The levels of P-selectin, CRP and cTnⅠ of patients with ACS are related to short-term prognosis, which can be used as the markers for risk stratification. Serial test of these factors may improve the predictive value.

关 键 词：急性冠状动脉综合征 P-选择素 C-反应蛋白 心肌肌钙蛋白Ⅰ 

分 类 号：R541.4[医药卫生—心血管疾病]