血清C-反应蛋白凝血因子Ⅰ与急性冠状动脉综合征的相关研究

The study of the relation between C-reactive protein, fibrinogen and acute coronary syndrome

目的 :探讨C 反应蛋白 (CRP)、凝血因子Ⅰ (FG)在急性冠状动脉综合征 (ACS)发病中的作用及意义。方法 :用速率散射比浊法测定ACS患者各组与非急性冠状动脉综合征 (NACS)组患者血清CRP、FG、肌钙蛋白I(cT nI)、肌酸磷酸激酶(CPK)、肌酸磷酸激酶同工酶 (CPK MB)、乳酸脱氢酶 (LDH)、α 羟丁酸脱氢酶 (α HAD)和谷草转氨酶 (GOT)水平。结果 :ACS患者血清CRP、FG、cTnI、心肌酶谱 (CPK、CPK MB、LDH、α HAD、GOT)峰值水平均显著高于NACS组 (P <0 .0 1 ) ;ACS患者中ST段抬高的心肌梗死 (STAMI)、非ST段抬高的心肌梗死 (NSTAMI)患者组血清CRP、FG、cTnI、心肌酶谱峰值水平均显著高于NACS组 (P <0 .0 1 ) ;不稳定型心绞痛 (UAP)患者组CRP、FG水平显著高于对照组 (P <0 .0 1 ) ,而cTnI、血清心肌酶谱水平与对照组相比差异无统计学意义 (P >0 .0 5 ) ;ACS患者CRP水平与血清cTnI、心肌酶谱峰值水平呈显著正相关 (P <0 .0 1 ) ;FG水平与α HAD峰值水平呈显著正相关 (P <0 .0 1 )。结论 :ACS患者血清CRP与疾病严重程度 (心肌损害)呈正相关。

Objective: To investigate the role of C-reactive protein (CRP ) and fibrinogen(FG ) in the the pathogenesis of acute coronary syndrome (ACS). Method: Rate nephelometry with the Beckman systems was used to measure the plasma levels of CRP, FG, cTnI, CPK, CPK-MB, LDH,α-HAD and GOT in patients with ACS and none ACS as control. Result: The peak levels of CRP, FG, cTnI, CPK, CPK-MB, LDH,α-HAD and GOT in ACS group were significantly higher than those of control group(P< 0.01). The peak levels of CRP, FG, cTnI, CPK, CPK-MB, LDH,α-HAD and GOT in STAMI and NSTAMI groups were also obviously higher than those of control group(P< 0.01). Although the levels of CRP and FG in UAP group were significantly higher than those of control group(P< 0.01), the levels of cTnI, CPK, CPK-MB, LDH,α-HAD and GOT in UAP group didn't significantly increase compared with non-ACS group(P> 0.05). The level of CRP in ACS group was positively correlated with the peak level of cTnI, CPK,CPK-MB, LDH,α-HAD and GOT(P< 0.01), the level of FG in ACS group was correlated with the peak level of α-HAD. Conclusion: The plasma levels of CRP and FG in ACS group are significantly elevated; the plasma level of CRP in ACS group is associated with the severity of the disease (myocardial damage), indicating that CRP play an important role in the pathogenesis of ACS.