炎性因子对急性冠状动脉综合征的早期预测价值

Prediction value of serum C-reactiveprotein, serum amyloid A, and interleukin-6 in acute coronary syndrome

目的:观察冠心病不同类型患者中血清炎性递质C反应蛋白(CRP)、淀粉样蛋白A(SAA)和白细胞介素-6(IL-6)水平的变化以及炎症递质之间的关系,探讨急性冠状动脉综合征(ACS)预测的炎症指标。方法:用酶联免疫吸附法检测了32例急性心肌梗死,30例不稳定型心绞痛,20例稳定型心绞痛和16例健康对照者血清CRP、SAA、IL-6水平,并比较上述指标与不同类型冠心病,ACS与非ACS之间的关系。结果:ACS患者血清CRP、SAA和IL-6均高于非ACS患者,分别为(6.94±4.56)∶(2.48±2.32)mg/L;(217.23±441.14)∶(18.18±28.05)mg/L;(4.37±6.35)∶(1.31±0.98)ng/L(均P<0·01)。CRP、SAA和IL-6三者之间呈显著正相关。以CRP、SAA和IL-6的x-±2s为截断值联合预测ACS的灵敏度为73.8%,特异度为91.7%,准确性为80.4%。结论:ACS患者血清SAA、CRP、IL-6水平升高,提示与ACS的发生有关,是动脉粥样硬化斑块不稳定的标志,可以作为ACS的早期辅助诊断指标。

Objective： To investigate the difference and relationships of serum C-reactive protein （CRP）, serum amyloid A （SAA）, and interleukin-6 （IL-6） levels in different subtype of coronary heart diseases and explore the potential predicting factors for the acute coronary syndrome （ACS）. Method： The levels of serum CRP, SAA, IL-6 in 32 acute myocardial infarction（AMI）, 30 unstable angina pectoris（UAP）, 20 stable angina pectoris（SAP） and 16 normal healthy control subjects were measured by enzyme-linked immunosorbent assay, comparing the values of CRP, SAA, IL-6 among different. Result： Serum CRP, SAA, IL-6 levels were significantly higher in the ACS group compared with normal group. They were （6.94±4. 56） ： （2.48±2.32）mg/L; （217.23±441.14） ： （18.18±28.05）mg/L; （4.37±6.35） ： （1.31±0.98）ng/L. （P 〈 0.01）. CRP, SAA, IL-6 levels were positively correlated with each other. For ACS, the sensitivity was 73.80%, specificity was 91.7%, accuracy was 80.4% with serum CRP, SAA, IL-6 levels. Conelusion： The elevated SAA, CRP, IL-6 levels suggested an obvious relationship with pathogenesis of ACS, which may be a potential markers of plaque instability and were regarded as the markers for early diagnosis of ACS.