急性时相反应蛋白在冠心病病变中的变化探讨

The Change of Acute Phase Reaction Protein in Patients with Coronary Heart Disease

目的:探讨急性时相反应蛋白(APRP)在冠心病(CHD)诊治中的意义。方法:采用散射比浊法及透射比浊法对52例冠心病患者诊治过程中血中C-反应蛋白(CRP)、淀粉样蛋白A(SAA)、前白蛋白(PA)等急性时相反应蛋白进行检测。结果:冠心病患者血中CRP、SAA明显高于对照组(P<0.01),且依照稳定性心绞痛(SAP)、不稳定性心绞痛(UAP)、急性心肌梗死(AMI)顺序显著增高(P<0.01);PA明显低于对照组(P<0.01),急性心肌梗死患者PA下降更为明显;经过治疗后,进入康复期的患者血中CRP、SAA的浓度显著下降(P<0.01),PA的浓度上升到接近健康对照水平(P>0.05)。相关分析表明:CRP与SAA之间呈正相关(r=0.78,P<0.05),与PA之间呈负相关(r=-0.51,P<0.05)。结论:APRP尤其是CRP、SAA是监测冠心病发病、严重程度及预后的又一类灵敏指标。

Objective: To investigate the value of acute phase reaction protein(APRP) in patients with coronary heart disease(CHD). Methods:The concentrations of C-reactive protein(CRP),serum amyloid A(SAA) and prealbumin(PA) in 52 patients with CHD were detected with the nephelometer measure and turbidimetry method and compared with that in 35 healthy controls. Results: The plasma CRP and SAA levels in CHD were markedly higher than that in normal controls(P<0.01). The severer the disease, the higher the levels(stable angina pectoris < unstable angina pectoris < acute myocardial infarction). The levels of CRP and SAA significantly decreased after treatment(P<0.01). The levels of PA was significantly lower than that in normal controls(P<0.01) and significantly creased after treatment. The analysis of linear correlation showed that the levels of CRP correlated positively with the SAA(r=0.78, P<0.05)and negatively with PA (r=-0.51, P<0.05). Conclusion: Measuring the level of acute phase reaction protein(special CRP+SAA) in patient with CHD is of great significance to diagnosis, therapy and prognosis.