超声联合hs-CRP检测在ACS诊断中的意义

Significance of ultrasound combining with hs-CRP in determining the diagnosis of ACS

目的:观察颈动脉超声检查联合血清高敏C反应蛋白(hs-CRP)检测在急性冠脉综合征(ACS)的诊断中的作用。方法:选取本院确诊为稳定性心绞痛(SAP组)40例,ACS(ACS组)70例,对上述入选患者行体表颈动脉超声、冠状动脉造影,并检测各组血清hs-CRP水平,分析颈动脉超声检查结果及患者血清hs-CRP水平与ACS的关联性,并设同期来院体检正常者30例(对照组)进行对比观察。结果:ACS组CIMT、颈动脉斑块发生率及血清hs-CRP水平均明显高于SAP组及对照组,差异有统计学意义(P<0.05);SAP组与对照组CIMT、颈动脉斑块发生率及血清hs-CRP水平比较,差异无统计学差异(P>0.05);hs-CRP≥4mg/L组ACS发生率、CIMT、斑块发生率明显高于hs-CRP<4mg/L组,差异具有统计学意义(P<0.05);1、2、3支冠脉病变患者颈总动脉的内膜-中膜厚度(CIMT)、颈动脉斑块发生率及血清hs-CRP水平均明显高于无冠脉病变患者,差异有统计学意义(P<0.05)。结论:ACS患者血清hs-CRP水平与颈动脉斑块发生率正相关,提示颈动脉超声联合hs-CRP检测可对ACS的诊断及预测预后有积极意义。

Objective：To observe the effects of carotid artery ultrasound combining with serum high sensitivity C-reactive protein（hs-CRP）in determining the diagnosis of acute coronary syndrome（ACS）.Methods：A total of 40 patients diagnosed with stable angina pectoris（SAP）and 70 cases with ACS were enrolled in our study.The above included patients underwent body surface carotid artery ultrasound and coronary angiography and the serum hs-CRP levels were determined.The association of the result of carotid artery ultrasound examination and the serum hs-CRP levels was analyzed.Meanwhile,30 healthy individuals who came for physical examination were served as the control group.Results：The CIMT,carotid plaque occurrence rate,and the serum hs-CRP levels in the ACS group were significantly higher than those in the SAP group and the control group,and there was a statistically significant difference between the groups（P〈0.05）;while the comparison between the SAP group and the control group was not statistically significant（P〉0.05）.The ACS incidence rate,CIMT,and the carotid plaque occurrence rate in the group with hs-CRP≥4mg/L were significantly higher than those in the group with hs-CRP〈4mg/L（P〈0.05）;the CIMT,carotid plaque occurrence rate,and the serum hs-CRP levels in the patients with coronary artery lesions of branch 1,2,and 3were significantly higher than those in the patients with no coronary artery lesions,and the difference was statistically significant（P〈0.05）.Conclusions：The serum hs-CRP level is positively correlated with carotid plaque occurrence rate in the ACS patients,suggesting that it is of great significance in determining the diagnosis and prognosis of ACS by the combination of carotid artery ultrasound and hs-CRP.