不稳定性心绞痛患者血清CRP和TnI含量的测定及临床意义  

Significance of serum C-reactive protein and troponin I changes in unstable angina

作　　者：王岩[1] 辛凤芝[1] 曹唯[1] 李学奇[1] 王慧斌[2] 丁新民[3] 

机构地区：[1]哈尔滨医科大学第二临床医学院心内科,黑龙江哈尔滨150086 [2]大庆油田总医院内分泌科,黑龙江大庆163000 [3]大庆油田总医院内血液科,黑龙江大庆163000

出　　处：《哈尔滨医科大学学报》2002年第4期313-315,共3页Journal of Harbin Medical University

摘　　要：目的　探讨C -反应蛋白 (CRP)和心肌肌钙蛋白I(TnI)在不稳定性心绞痛 (UA)发病机制中的意义及对预后判断的价值。方法　测定 30例UA患者和 11例稳定性心绞痛 (SA)患者血清CRP和TnI,并与CK -MB相比较 ,同时观察住院期间及随访 1～ 3个月中心脏事件的发生。结果　UA组患者血清CRP含量为 (8.5 6± 2 .0 5 )mg L ,与SA组 (2 .31± 0 .5 9)mg L相比有极显著性差异 (P =0 .0 0 5 ) ;UA组患者血清TnI含量为 (4 .2 5± 1.32 )ng ml,与SA组(0 .2 7± 0 .11)ng ml相比有显著性差异 (P =0 .0 3)。UA组患者血清CRP含量与TnI含量呈一定程度的相关性 (r =0 .5 7,P =0 .0 0 6 )。伴有CRP及TnI升高的UA患者住院期间心绞痛发作次数与正常患者相比明显增多 (P分别为0 .0 0 3和 0 .0 2 ) ,心肌梗死的发生率增高。结论　炎症反应是UA发病的一个重要因素 ;在UA中存在微小心肌损伤 ,TnI是判断微小心肌损伤的敏感指标 ;Objective To investigate the role of serum cardiac specific troponin I (TnI), C-reactive protein (CRP) in the mechanism of unstable angina (UA).Methods TnI,CRP and creatine kinase isoenzyme MB (CK-MB) activity were measured by enzyme immunoassay method in 30 patients with UA within 24 hours after admission to the hospital and 11 patients with stable angina (SA). The outcomes of interest during the hospitalization were the onset of intractable angina, acute myocardial infarction (AMI) and sudden death.Results In patients with UA, both CRP and TnI exhibited higher levels than those in patients with SA(P=0.005,P=0.03 respectively ).In UA group, a modest correlation was found between CRP and TnI (r=0.57,P=0.006). The onset of episode of ischeamia occurred more often in patients with high levels of CRP or TnI than in patients with normal levels in UA group(P=0.003.P=0.02 respectively).Conclusion A specific inflammatory process and minor myocardial damage (MMD) occur in UA. Increased levels of both CRP and TnI are associated with a worse outcome in patients with UA.

关 键 词：血清 临床意义 不稳定性心绞痛 C-反应蛋白 肌钙蛋白I 发病机制 

分 类 号：R541.4[医药卫生—心血管疾病]