血浆CRP及NT-proBNP与急性冠脉综合征关系的研究  

Study on relationship between plasma CRP and NT-proBNP and acute coronary syndrome

作　　者：王庆芳[1] 张靖宇[1] 曲蕴慧[1] 秦东春[1] WANG Qing-fang;ZHANG Jing-yu;Qu Yun-hui;QIN Dong-chun(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院检验科,郑州450052

出　　处：《医药论坛杂志》2018年第7期1-3,6,共4页Journal of Medical Forum

基　　金：河南省科技攻关项目(172102310077)

摘　　要：目的探讨不同危险分层急性冠脉综合征(ACS)患者在发作期血浆C反应蛋白(CRP)、N末端脑利钠肽前体(NT-pro BNP)水平的变化及其对ACS诊断、病情评估等的临床价值。方法收集郑州大学第一附属医院2015年1月—2016年12月心内科收治的ACS患者224例,其中不稳定心绞痛患者组(UA组)87例,非ST段抬高型心肌梗死组(NSTEMI组)56例,ST段抬高型心肌梗死组(STEMI组)81例,同时采集健康体检者120例血浆作为对照组。采用电化学发光发测定其血浆NT-pro BNP浓度,采用免疫比浊法检测其CRP含量,并对检测结果进行统计分析。结果 ACS各危险分层患者血浆CRP及NT-pro BNP水平均高于健康对照组,差异有统计学意义(P<0.001);NSTEMI组与STEMI组血浆CRP及NT-pro BNP均高于不稳定性心绞痛(UA)组,且差异有统计学意义(P<0.001);STEMI组CRP水平[(18.46±3.04)mg/L]高于NSTEMI组,差别有统计学意义(P<0.05),但STEMI组NT-pro BNP水平虽然高于NSTEMI组,差异无统计学意义(P>0.05)。结论血浆CRP及NT-pro BNP可以作为ACS鉴别诊断、病情严重程度评估的良好指标,CRP与BNP联合检测更有助于ACS的危险分层。Objective To investigate the changes of plasma C reactive protein（ CRP） and N end brain natriuretic peptide（ NT-pro BNP） levels in patients with acute coronary syndromes with different risk stratification and their clinical value in the diagnosis of ACS and the evaluation of the condition of the disease. Methods We collected 224 ACS patients of Department of cardiology ward of the first affiliated hospital of Zhengzhou university from January 2015 to December 2016,including patients with unstable angina pectoris（ UA） group 87 cases,non ST elevation myocardial infarction（ NSTEMI） group 56 cases,ST segment elevation myocardial infarction（ STEMI） group in 81 cases,and 120 cases of healthy people were collected as control group. We have detected plasma concentrations of NT-pro BNP by electrochemical and plasma CRP contents using the immunoturbidimetric assay and the detection results were analyzed.Results ACS the risk stratification of patients with plasma CRP and NT-pro BNP were higher than that of the control group,the difference was statistically significant（ P 0. 001）; NSTEMI group and STEMI group,plasma CRP and NT-pro BNP were higher in patients with unstable angina pectoris（ UA） group,there was significant difference（ P 0. 001）; and the level of CRP in STEMI group was higher than that in group NSTEMI,there are statistically significant difference（ P〈 0. 05）,But the NT-pro BNP level of STEMI group is higher than that of NSTEMI group,no significant difference was found（ P〈 0. 05）. Conclusion The plasma CRP and NT-pro BNP ACS can be used as a good index of differential diagnosis,severity evaluation. The combined detection of CRP and BNP is more conducive to the risk stratification of ACS.

关 键 词：C反应蛋白 N末端脑利钠肽前体 急性冠脉综合征 急性非ST段抬高性心肌梗死 急性ST段抬高性心肌梗死 不稳定型心绞痛 

分 类 号：R446.6[医药卫生—诊断学]