高敏C-反应蛋白对急性冠脉综合征患者预后的预测价值

The Rasearch of High Senstive C-Reactive Protein in Predictive Value of Prognosise in Acute Coronary Syndrome

目的探讨高敏C-反应蛋白(hs-CRP)对急性冠脉综合征(ACS)预后的预测价值。方法选择我院冠脉综合征患者181例,其中不稳定型心绞痛组135例(UAP组),急性心肌梗死46例(AMI组),另选同期住院稳定型心绞痛患者58例(SAP组)和门诊体检健康人50例(健康对照组),UAP患者又按Braunwald分为Ⅰ级36例,Ⅱ级41例,Ⅲ级患者58例,观察4组研究对象hs-CRP水平及UAPⅠ、Ⅱ、Ⅲ级患者的hs-CRP水平。结果4组研究对象hs-CRP间差异均有非常显著性意义(P<0·01),两两比较各组间差异亦有显著性意义(P<0·05),UAP组Ⅰ、Ⅱ、Ⅲ级患者hs-CRP间差异有非常显著性意义(P<0·01),且Ⅰ级与Ⅲ级,Ⅱ级与Ⅲ级间差异均有非常显著性意义(P<0·01)。结论ACS患者血清hs-CRP水平与其病情严重程度呈正相关,提示hs-CRP水平可作为ACS危险分层和预后的预测因子。

Objective To study the significance of the level of high senstive C - reactive protein （ hs - CRP） of the risk stratification in acute coronary syndrome （ACS）. Methods The patients were divided into ACS group, stable angina pectoris （SAP） group and control group. The UAP group was classified according to Braunwald class. The results of serum hs - CRP levels in differentent groups were compared and the data were statistically analyzed. Results The hs - CRP levels in ACS group were significantly higher than those in SAP group and control group （ P 〈0. 01 ）. In UAP group, the increase of hs - CPR levels were closely correlated with the severity of Brannwald class （ P 〈0. 01）. At 3d to 7d of AMI in -hospital, in comparison with the patients with decreased hs - CRP levels, the patients with continuous elevated or no - descended hs - CRP levels have a high incidence of severity complications and cardiac events during the 6 - month follow - up period. Conclusion The levels of hs - CRP in ACS was positively accociated with the severity of disease, which is a predictive factor of the prognosis and risk strat- ificatin in ACS.