长正五聚蛋白-3与高敏C反应蛋白在急性冠状动脉综合征的变化及意义

Significance and change of pentraxin-3 and hsCRP in the patients with acute coronary syndrome

目的:探讨长正五聚蛋白-3(PTX-3),高敏C反应蛋白(hsCRP)在急性冠状动脉综合征中的变化及意义。方法:入选经冠状动脉造影患者170例。用ELISA法测定血浆PTX-3浓度,比较各组间差异。并与hsCRP比较。结果:①急性心肌梗死患者PTX-3浓度显著高于不稳定型心绞痛组[(7.20±4.44)μg/L,(6.12±3.55)μg/L,P<0.05]、稳定型心绞痛组[(4.02±2.75)μg/L,P<0.05]、正常对照组[(3.14±1.94)μg/L,P<0.05];不稳定型心绞痛PTX-3浓度显著高于稳定型心绞痛组[(4.02±2.75)μg/L,P<0.05]、正常对照组[(3.14±1.94)μg/L,P<0.05];②血浆PTX-3 ROC曲线下面积0.77,hsCRP曲线下面积0.65。血浆PTX-3的敏感度、特异度分别为72.6%和70.6%。血浆hsCRP的敏感度、特异度分别为54.2%和62.5%。血浆PTX-3对急性冠状动脉综合征诊断价值较hsCRP高,有更好的敏感性及特异性。结论:血浆PTX-3浓度与急性冠状动脉综合征有相关性,可以反映冠心病动脉粥样硬化的稳定程度,较hsCRP有更好的敏感性及特异性。

Objective：This study was designed to assess the clinical significance and change of serum pentraxin-3（PTX-3）、hsCRP levels in the patients with Acute Coronary Syndrome（ACS）.Method：The study included 170 subjects who were underwent coronary angiography.We measured the Serum pentraxin-3 levels by enzyme-linked immunosorbent assay（ELISA） methods.Serum pentraxin3 level and hsCRP were compared among different groups.Result：The Levels of serum pentraxin3 were significantly higher in patients with acute myocardial infarction than unstable angina pectoris（7.20±4.44 μg/L,6.12±3.55 μg/L,P0.05）、stable angina pectoris（SAP）（4.02±2.75 μg/L,P0.05） and non-CAD subjects（3.14±1.94 μg/L,P0.05）.UAP patients tend to have higher pentraxin-3 levels than SAP patients and non-CAD subjects.The area under the ROC of PTX-3 is 0.77（P0.01）,and hsCRP is 0.65（P0.01）.The sensitivity and specificity of diagnosing CAD were 72.6% and 70.6% by PTX-3 alone,54.2% and 62.5% by hsCRP alone.Compared with hsCRP,serum PTX-3 had better diagnostic value.Conclusion：As an inflammatory indicator,pentraxin3 is closely related to acute coronary syndrome and is a risk factor of ACS.Serum pentraxin-3 levels reflect the stabilization of coronary artery atherosclerosis,and it is associated with CAD more closely than hsCRP.