急性冠状动脉综合征患者ST段变化与高敏C反应蛋白的关系

Relationship between High-sensitivity C-Reactive Protein and the Electrocardiographic ST Segment Change in Patients with Acute Coronary Syndrome

目的观察急性冠状动脉综合征患者ST段变化与高敏C反应蛋白(hs-CRP)的关系。方法急性心肌梗死患者136例,根据入院时的心电图变化分为3个组:ST段上抬组59例,ST段下移组50例,心电图正常组27例。所有患者入院后即检测hs-CRP水平,采用的截点值为3 mg/L。结果ST段下移组hs-CRP水平超过截点值者显著较其它两组多(P=0.009)。ST段下移组hs-CRP水平明显高于ST段抬高组和正常组(P<0.01)。1年后随访,ST段下移组心血管事件发生率高于ST抬高组和正常组(P<0.05)。结论ST段下移患者hs-CRP水平增高有较高的发生率,提示炎症诱发临床急性冠状动脉综合征呈明显的不均一性。入院时hs-CRP浓度较高患者预后较差。

Objective To research the relationship between high-sensitivity C-reactive protein and the electrocardiographic ST segment change in patients with acute coronary syndrome. Methods Hundred and thirty-six consecutive patients with the diagnosis of acute myocardial infarction were divided in three groups（59 patients with ST segment elevation,50 patients with ST depression and 27 patients with no ECG changes） according to the ECG pattern on admission.Hs-CRP was measured on admission in all patients.A cutoff value of 3 mg/L was used for the prevalence of inflammation analysis. Results Hs-CRP was above cutpoint significantly more often in patients with ST depression（P=0.009）.hs-CRP levels of ST depression group was higher than group of ST segment elevation and no ECG changes.Patients with similar ECG pattern and hs-CRP levels above the cutpoint presented a poorer outcome at one-year follow-up. Conclusions Patients with ST depression on admission exhibit a higher prevalence of elevated hs-CRP than those with ST elevation or no ECG changes,suggesting an important heterogeneity of the role of inflammatory triggers of the clinical syndromes of coronary instability.Patients with higher levels of hs-CRP on admission presented a poorer outcome.