高敏C反应蛋白联合高敏心肌肌钙蛋白T对急性冠状动脉综合征患者预后的判断价值  

The value of high-sensitivity C-reactive protein combined with high-sensitivity cardiac troponin T for prognosis of patients with acute coronary syndrome

作　　者：李永勤[1] 范艳梅[1] 薛嘉红[1] 张春燕[1] 张岩[1] 栾春红[1] 

机构地区：[1]西安交通大学医学院第二附属医院心内科,710004

出　　处：《中国医师进修杂志》2014年第22期5-9,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察高敏C反应蛋白（hs-CRP）联合高敏心肌肌钙蛋白T（hs-cTnT）对急性冠状动脉综合征（ACS）患者预后的判断价值。方法选择2011年7月至2012年12月诊断为ACS的患者118例，根据临床表现分为3组：不稳定型心绞痛（UAP）组38例、非ST段抬高型心肌梗死（NSTEMI）组38例，ST段抬高型心肌梗死（STEMI）组42例。对人选患者进行为期3个月的随访，观察各组心血管事件及心源性死亡的发生情况。另选择20例门诊健康体检者作为对照组。结果UAP组、STEMI组和NSTEMI组入院时血清hs-CRP含量均高于对照组，其中NSTEMI组升高最为明显，显著高于STEMI组和UAP组，差异均有统计学意义（P〈0．05）。血清hs-cTnI含量在STEMI组和NSTEMI组均升高，且STEMI组升高程度高于NSTEMI组，差异均有统计学意义（P〈0．05）。UAP组、NSTEMI组和STEMI组入院时血清hs-CRP含量≥3mg／L患者出院后3个月内心血管事件及心源性死亡总发生率分别为6／11，40．0％（12／30），46．4％（13／28），明显高于血清hs-CRP含量〈3mg／L患者的11．1％（3／27），3／8，5／14，差异有统计学意义（P〈0．05）；NSTEMI组和STEMI组入院时血清hs-cTnT含量≥1．0μg／L的患者出院后3个月内心血管事件及心源性死亡总发生率分别为16．7％（5／30），18．4％（7／38），明显高于血清hs-cTnT含量〈1．0μg／L患者的1／8，1/4，差异有统计学意义（P〈0．05）。结论血清hs-CRP含量显著升高是ACS患者不良预后的重要预测指标，联合hs-cTnT的升高有助于早期鉴别高危患者。对这类患者及时给予强化治疗及出院后密切监测，可减少心血管事件的发生。Objective To investigate the value of high-sensitivity C-reactive protein （hs-CRP） combined with high-sensitivity cardiac troponin T （hs-cTnT） for prognosis of patients with acute coronary syndrome （ACS）. Methods One hundred and eighteen patients with ACS were selected from July 2011 to December 2012. According to the clinical feature, they were divided into unstable angina pectoris （UAP） group （38 cases）,non ST segment elevation myocardial infarction （NSTEMI） group （38 cases） and ST segment elevation myocardial infarction （STEMI） group （42 cases ）. They were followed up for 3 months, and the incidence of cardiovascular events and cardiac death was observed. Twenty healthy people were selected as control group. Results The serum level of hs-CRP on admission in UAP group, STEMI group, NSTEMI group was higher than that in control group,and NSTEMI group was highest. And there was significant difference between NSTEMI group and STEMI group, and also between NSTEMI group and control group （P 〈 0.05）. The serum level of hs-cTnI was increased in STEMI group and NSTEMI group. The increased degree in STEMI group was higher than that in NSTEMI group,and there was significant difference （P 〈 0.05）. The incidence of cardiovascular events and cardiac death within 3 months after discharge in patients with the serum level of hs-CRP ≥ 3 mg/L on admission in UAP group and NSTEMI group, STEMI group was 6/11,40.0% （12/30）,46.4% （13/28）, which was higher than that in patients with the serum level of hs-CRP 〈 3 mg/L[ 11.1% （ 3/27 ）, 3/8,5/14 ], and there was significant difference（P 〈 0.05 ）. The incidence of cardiovascular events and cardiac death within 3 months after discharge in patients with the serum level of hs-cTnT ≥1.0 μg/L on admission in NSTEMI group and STEMI group was 16.7% （5/30） and 18.4% （7/38）, which was higher than that in patients with the serum level of hs-cTnT 〈 1.0 tx g/L （1/8,1/4）, and there was significant difference （P �

关 键 词：C反应蛋白质 肌钙蛋白T 急性冠状动脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]