超敏C-反应蛋白、肌钙蛋白I与急性冠状动脉综合征患者近期心脏事件的相关性

High Sensitivity C-reactive Protein, Cardiac Troponin I and Early Cardiac Events of Patients with Acute Coronary Syndrome

目的探讨超敏C-反应蛋白（hsCRP）、肌钙蛋白I（cTnI）水平与急性冠状动脉综合征（ACS）患者近期心脏事件发生的关系。方法（1）采用化学发光免疫分析法检测50例ACS患者胸痛后8-12h血清hsCRP及cTnI水平,20例陈旧性心肌梗死（OMI）患者和20例对照组的hsCRP、cTnI水平。（2）以心脏事件为因变量,分别以cTnI、hsCRP为自变量进行Logistic单因素分析;用前进法（Forward：LR）观察两者进入多因素Logistic回归模型,分析ACS患者住院期间心脏事件发生的危险因素。结果（1）ACS组的hsCRP、cTnI均高于OMI组和对照组（P〈0.05）;OMI组的hsCRP、cTnI水平和对照组相比,有升高趋势,但差别无统计学意义（P〉0.05）。（2）ACS患者中,有心脏事件发生者hsCRP、cTnI水平显著高于无心脏事件发生者（P〈0.05）。（3）ACS患者住院期间,hsCRP升高者心脏事件发生率高于hsCRP正常者（P〈0.05）;cTnI升高组心脏事件发生率高于cTnI正常者（P〈0.05）;hsCRP、cTnI均升高组心脏事件发生率高于hsCRP、cTnI均正常者（P〈0.05）。（4）Logistic分析显示：hsCRP、cTnI的水平是ACS患者住院期间发生心脏事件的独立危险因素。结论ACS患者血清hsCRP、cTnI水平升高;且ACS患者血清hsCRP、cTnI水平越高,近期发生心脏事件的危险性越大。

Objective To investigate the relationship between serum high sensitivity C-reactive protein（hsCRP）, cardiac troponin I（cTnI） and the incidence of major cardiac events of the patients with acute coronary syndrome（ACS）. Methods Serum levels of hsCRP, cTnI were measured by chemiluminescence immunoassay. The levels of serum hsCRP and cTnI were detected 8-12 h after acute chest pain in the patients with ACS. Results （1） Serum levels of hsCRP and cTnI were higher in the ACS group than that in the old myocardial infarction（OMI） and control group（P〈0.05）. The levels of hsCRP and cTnI in the OMI group were higher than that in the control group, but were not statistical significance （P〉0.05）. （2）Serum levels of hsCRP and cTnI were higher in patients with major cardiac events than that in those without such events（P〈0.05）. （3）The incidence of major cardiac events was significantly higher among patients with increased levels of hsCRP than that in other patients（P〈0.05）. The incidence was significantly higher among patients with increased levels of cTnI than that in other patients（P〈 0.05）. The incidence was also significantly higher among patients with increased levels of hsCRP and cTnI than that in patients with normal levels of hsCRP and cTnI（P〈0.05）. （4）With Logistic regression, the result indicates the effect of hsCRP, cTnI was a independent risk factor in the incidence of major cardiac events during the hospital in the ACS group. Serum levels of hsCRP,cTnI are significantly higher in the ACS group than those in the OMI and control group. Conclusion With the increase of serum levels of hsCRP and cTnI in patients with ACS, the incidence of early major cardiac events becomes higher.