老年急性冠脉综合征患者氨基末端脑钠肽前体、血小板P选择素、超敏C反应蛋白检测及对预后的影响

The Detection and Prognosis of NT-proBNP,P-selection and hs-CRP Levels in Elderly Patients with Acute Coronary Syndrome

目的监测老年急性冠脉综合征(ACS)患者氨基末端脑钠肽前体(NT-proBNP)、血小板P选择素(P-selection)和超敏C反应蛋白(hs-CRP)水平的变化,并对其预后进行临床探讨。方法选取60例老年ACS患者,其中急性心肌梗死(AMI)30例,不稳定型心绞痛(UAP)30例,另设对照组30例。采用酶联免疫吸附法测定NT-proBNP、全血法流式细胞术测定P-selection及胶乳免疫增强比浊法测定hs-CRP水平。同时探讨三指标之间的相关关系,并对老年ACS患者进行预后随访。结果老年ACS患者NT-proBNP、P-selection、hs-CRP水平均高于对照组(P<0.0 5);老年ACS患者NT-proBNP与P-selection呈正相关(r=0.225,P<0.05),NT-proBNP与hs-CRP呈正相关(r=0.615,P<0.01),P-selection与hs-CRP呈正相关(r=0.335,P<0.01);老年AMI患者较老年UAP患者发生心脏不良事件发生率显著升高。结论 NT-proBNP、P-selection、hs-CRP参与了ACS的发病机制,同时检测三指标可以作为老年ACS患者心肌缺血损伤程度、预后判断及早期干预治疗的一个无创性量化指标。

Objective To observe the changes of amino-terminal pro-brain natriuretic peptide(NT-proBNP),platelet P-selection and high-sensitivity C-reactive protein(hs-CRP)levels in elderly patients with acute coronary syndrome(ACS).Methods Sixty patients with ACS were selected,including acute myocardial infarction(AMI)30cases and unstable angina pectoris(UAP)30cases.Thirty healthy individuals were as the controls.The levels of NT-proBNP were detested by enzyme-linked immunosorbent assay.The levels of P-selection were detested by whole blood flow cytometry.The levels of hs-CRP were detested by enhanced turbidimetric immunoassay.the relationship among the three indicators,investigated.Results The levels of NT-proBNP,P-selection and hs-CRP in elderly patients with ACS were higher than that in controls(P<0.05).NT-proBNP and P-selection in elderly patients with ACS was positively correlated(r=0.225,P<0.05).NT-proBNP and hs-CRP were positively correlated(r=0.615,P<0.01).P-selection and hs-CRP were positively correlated(r=0.335,P<0.01).The incidence of adverse cardiac events in elderly patients with AMI was significantly higher than that in elderly patients with UAP.Conclusion NT-proBNP,P-selection,hs-CRP involved in the pathogenesis of ACS.Simultaneous detection of three indicators could be used as a non-invasive quantitative indicators for myocardial ischemia injury severity,prognosis and early intervention in in elderly patients with ACS.