不稳定型心绞痛C反应蛋白、白介素-6和纤维蛋白原水平的动态测定及意义  

Dynamic measurement of CRP, IL-6 and Fib levels of unstable angina and its clinical significance

作　　者：姜虹[1] 厉吉霞[1] 王梅春[1] 

机构地区：[1]烟台市烟台山医院检验科,山东省烟台264001

出　　处：《中国基层医药》2015年第2期261-263,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨动态测定不稳定型心绞痛（UAP）患者血清CRP、IL-6和纤维蛋白原（Fib）水平的临床意义.方法 选择UAP患者162例为UAP组（其中低危组52例、中危组53例、高危组57例）,另选择同期体检的健康人58例为对照组,检测两组CRP、IL-6和Fib含量,观察UAP患者出院后心脏事件发生情况.结果 出院时UAP低危组CRP、IL-6、Fib含量分别为（3.47±0.55） mg/L、（10.38±1.57） ng/L、（1.64土0.65）g/L,均显著低于入院时含量[（6.50±0.87） mg/L、（14.35±1.22） ng/L、（3.01 ±0.28） g/L]（t=2.761、2.945、2.118,P=0.028、0.003、0.031）;中危组CRP、IL-6、Fib含量分别为（6.87±0.75） mg/L、（14.35±1.02） ng/L、（2.26±0.33）g/L,均显著低于入院时含量[（9.21±1.03） mg/L、（19.24±1.58） ng/L、（4.15 ±0.47） g/L]（t =2.985、3.157、3.548,P=0.003、0.001、0.000）;高危组CRP、IL-6、Fib含量分别为（8.71±0.84） mg/L、（17.37±1.26） ng/L、（4.67±0.85）g/L,均显著低于入院时含量[（12.48±1.24） mg/L、（25.13±1.84） ng/L、（7.28 ±0.64） g/L]（t=3.472、4.018、5.097,P=0.000、0.000、0.000）.出院后半年CRP、IL-6、Fib升高组心脏事件发生率分别为40.20％、40.35％、47.50％,均显著高于正常组的5.00％、4.17％、14.29％（χ^2=23.655、2.211、14.442,P=0.000、0.000、0.000）.结论 UAP患者CRP、IL-6、Fib含量明显高于健康人群,且随着病情缓解,含量有所降低,是反映UAP患者病情严重程度的有效指标,但其特异性差,需慎重使用.Objective To study the clinical significance of dynamic determination of serum CRP,IL-6 and fibrinogen（Fib） levels in unstable angina pectoris （UAP） patients.Methods 162 UAP patients were selected as UAP group（including 52 cases of low risk group,53 cases in medium risk group and 57 cases in high risk group）,58 healthy people were selected as control group.The CRP,IL-6 and Fib contents were observed in UAP patients after cardiac events.Results At discharge,CRP,IL-6,Fib in UAP low risk group were （3.47 ±0.55）mg/L,（10.38 ± 1.57） ng/L,（1.64 ± 0.65） g/L,which were significantly lower than the admission contents [（6.50 ±0.87） mg/L,（14.35 ± 1.22） ng/L,（3.01 ± 0.28） g/L] （t =2.761,2.945,2.118,P =0.028,0.003,0.031）.CRP,IL-6,Fib levels in the medium risk group were （6.87±0.75） mg/L,（14.35 ± 1.02） ng/L,（2.26 ± 0.33） g/L,which were significantly lower than the admission contents [（9.21±1.03） mg/L,（19.24±1.58） ng/L,（4.15 ±0.47） g/L] （t =2.985,3.157,3.548,P =0.003,0.001,0.000）.CRP,IL-6,Fib levels in the high risk group were （8.71 ±0.84） mg/L,（17.37 ± 1.26） ng/L,（4.67 ±0.85） g/L,which were significantly lower than the admission contents [（12.48 ± 1.24） mg/L,（25.13 ± 1.84） ng/L,（7.28 ± 0.64） g/L] （t =3.472,4.018,5.097,P =0.000,0.000,0.000）.Six months after hospital discharge,in CRP,IL-6,Fib elevated groups,the incidence rates of cardiac event were 40.20%,40.35% and 47.50%,which were significantly higher than those in normal group （5.0%,4.17%,14.29%,χ^2=23.655,2.211,14.442,P=0.000,0.000,0.000）.Conclusion CRP,IL-6 and Fib levels in UAP patients were significantly higher than those in healthy people,and with remission,contents would be lower,which was the index to reflect the severity of UAP,but its specificity is bad,need to use caution.

关 键 词：心绞痛 不稳定型 C反应蛋白质 白细胞介素-6 纤维蛋白原 

分 类 号：R541.4[医药卫生—心血管疾病]