尿微量白蛋白联合C反应蛋白对非糖尿病非ST段抬高急性冠状动脉综合征预后的判断价值

Prognostic value of Microalbuminuria and C-reactive protein levels of non-ST elevation acute coronary syndrome in non-diabetic persons

目的评价联合检测尿微量白蛋白和血清C反应蛋白(C-reactive proteinCRP)对非糖尿病非ST段抬高急性冠状动脉(冠脉)综合征患者预后的判断价值。方法对入选的非ST抬高的急性心肌梗死及不稳定性心绞痛的患者检测尿微量白蛋白和血清CRP,然后根据微量白蛋白和CRP的水平分组,随访6个月观察各组心血管不良事件的发生率。结果与尿微量白蛋白正常组比较,尿微量白蛋白升高组复发心绞痛及总的心血管不良事件发生率显著升高(P<0.05),与CRP正常组比较,CRP升高组总的心血管不良事件发生率显著升高(P<0.05),与A组(尿微量白蛋白<30mg/L和CRP<10mg/L)相比,B组(尿微量白蛋白≥30mg/L或CRP≥10mg/L)和C组(尿微量白蛋白≥30mg/L和CRP≥10mg/L)总的主要心血管不良事件(MACE)发生率均显著增加(P<0.05);与B组相比,C组总的重要心血管不良事件(MACE)发生率显著增加(P<0.05)。结论尿微量白蛋白和C反应蛋白均对非糖尿病非ST段抬高急性冠脉综合征预后有判断价值,联合测定对患者预后的评估更有意义。

[Objective] To investigate the prognostic value of Mieroalbum inuria and C-reactive protein （CRP） levels of non-ST elevation acute coronary syndrome（ACS） in non-diabetic persons. [Methods] Microalbuminuria and CRP levels were measured in non-diabetic patients with non-ST elevation myocardial infarction （NSTEMI） or unstableangina（UA）. The eases were divided into groups according to the Mieroalbuminuria and CRP levels. The major adverse cardiovascular events （MACE） were analyzed. [Results] The attack frequency of angina pectoris and the incidences of total MACE significantly increased in Microalbuminuria elevated group than that in Mieroalbuminuria normal group （all P〈0.05）. The incidences of total MACE in CRP elevated group is higher than that in CRP normal group （P 〈0.05）.The incidences of total MACE significantly increased in group B （Microalbuminuria ≥ 30 mg/L or CRP≥ 10 mg/L）and group C （Microalbuminuria≥30 mg/L and CRP≥3 mg/L） than that in group A（Microalbuminuria 〈30 mg/L and CRP〈3 mg/L）（all P 〈0.05）.The incidences of total MACE in group C is higher than that in group B（P〈 0.05）. [Conclusion] Microaibuminuria and CRP levels were associated with the overall incidences of MACE in non-diabetic patients with non-ST elevation acute coronary syndrome. They could be used as markers for risk stratification in non-ST elevation acute coronary syndrome. Microalbuminuria and CRP combined together is more valuable than one of them in prognosis.