血清超敏C反应蛋白及肌钙蛋白Ⅰ在急性胸痛患者急诊科危险分层中的价值

The Value of hs-CRP and cTn-Ⅰin Risk Aanalysis on Patients with Acute Chest Pain in Department of Emergency

目的:探讨联合检测血清超敏C反应蛋白(hs-CRP)及肌钙蛋白I(cTn-I)对急性冠脉综合征(ACS)早期诊断的临床价值。方法:64例急性胸痛患者分别在来诊后0～2小时、2-4小时、4～6小时测定hs-CRP和cTn-I水平,并完善心电图、冠脉造影或冠脉CTA以确诊病因。结果:64例急性胸痛患者最终确诊ACS 36例,ACS组hs-CRP检测值在0-2小时即升高,且随时间延长逐步上升,在0～2小时、2～4小时及4～6小时点其检测值均较非ACS组明显升高(P<0.05);而cTn-I检测值在0～2小时组ACS患者与非ACS组无明显差异(P>0.05),在2～4小时及4～6小时ACS患者较非ACS组明显升高(P<0.05)。结论:联合检测急性胸痛患者的hs-CRP和cTn-I对ACS的早期诊断有重要价值,而hs-CRP比cTn-I能更早地起到提示作用。

Objective： To explore the clinical value of hs-CRP and cTn-I in early diagnose of acute coronary syndrome （ACS）. Methods： 64 patients with acute chest pain were tested hs-CRP and cTn-I within 0-2 h, 2-4 h and 4-6h after arrived hospital, and were completed electrocardiogram, coronary angiogram or CT to make a definite diagnosis. Results： 36 cases were diagnosed AC5 at last in 64 patients with acute chest pain. The level of hs-CRP increased within 0-2 h, and became more higher complied with the time extension. The level of hs-CRP in patients with AC$ increased gradually within 0-2 h, 2-4 h and 4-6 h compared with normal subjects（P 〈 0.05）. The level of cTn-I had no difference between patients with ACS and normal subjects within 0-2 h（P 〉 0.05）,but the difference in patients with AC$ compared with normal subjects within 2-4h and 4-6h was statistically significant （P 〈 0.05）. Conclusions： Detecting both of hs-CRP and cTn-I have important value on early diagnosis in patients with acute chest pain, and hs-CRP could detect positive result more early than cTn-I.