hs-CRP、BNP及D-二聚体与ACS近期不良心血管事件的关系

Relationship between hs-CRP,BNP,D-dimer and recent adverse cardiovascular events in patients with acute coronary syndrome

目的:探讨急性冠状动脉综合征(ACS)患者血清中高敏C反应蛋白(hs-CRP)、脑利钠肽(BNP)、D-二聚体的水平与近期不良心血管事件的关系,为临床诊治提供依据。方法:选择冠心病患者376例,均行冠状动脉造影检查,其中稳定型心绞痛(SAP)120例,不稳定型心绞痛(UAP)152例,非ST段抬高性心肌梗死(NSTEMI)30例及ST段抬高性心肌梗死(STEMI)74例。采用双抗夹心免疫荧光法检测BNP浓度;采用免疫比浊法测定hs-CRP、D-二聚体。出院后90d以电话、复查等手段随访本人或亲属,询问并记录不良心血管事件。结果:UAP、NSTEMI和STEMI外周血hs-CRP、BNP和D-二聚体水平依次升高,差异有统计学意义。同时3组不良心血管事件发生率UAP组最低(4.61%),NSTEMI组次之(16.67%),STEMI组最高(24.32%),其中UAP组和NSTEMI组、UAP组和STEMI组进行比较,差异有统计学意义;STEMI组不良事件发生率较NSTEMI组高,但差异无统计学意义。高血压病、hs-CRP、BNP、D-二聚体、LDL是ACS患者近期不良心血管事件的高危影响因素。结论:外周血hs-CRP、BNP、D-二聚体是反映ACS患者近期心血管事件的有效指标。

Objective：To explore the relationship between hs - CRP, BNP, d-dimer and recent adverse cardiovascular events in the patients with acute coronary syndromes（ACS）. Method： 376 cases were chosed and performed coronary arteriography examination, including 120 cases with stable angina pectoris （SAP）, 152 cases with unstable angina pectoris （UAP）, 30 cases NSTEMI, 74 cases STEMI. We used immune fluorescence to detect BNP concentration. Immune turbidimetric method was used to determine the levels of hs-CRP and D-dimmer. Pa- tients were followed up by telephone at 90 days after discharge, and recorded adverse cardiac events. Result：The incidence of adverse events in UAP group, NSTEMI group and STEMI group were 4.61%, 16.67% and 24.32% （P〈0.05） respectively. The levels of hs-CRP, BNP, D-dimer in STEMI group were higher than those in UAP and NSTEMI groups. Hypertension, hs-CRP, BNP, D - dimer, LDL were the high risk factors of the recent cardiac events in patients with ACS. Conclusion：hs-CRP, BNP, D-dimer are effective indicators of the recent cardiac events in patients with ACS.