急性冠脉综合征患者血清正五聚蛋白和超敏C反应蛋白水平变化与预后的关联

Changes of serum pentraxins and high-sensitivity C-reactive protein and correlation between them and prognosis in patients with acute coronary syndrome

目的：探讨急性冠脉综合征（ACS）患者血清正五聚蛋白（PTX-3）和高敏C反应蛋白（hs-CRP）水平变化及其与预后的关联。方法选自2012年4月至2013年4月吴忠市新区医院心内科临床诊断为冠状动脉粥样硬化性心脏病（冠心病）的患者132例，男性81例，女性51例，年龄范围40-75岁，分为稳定型心绞痛35例（SAP组），不稳定型心绞痛患者36例（UAP组），非ST段抬高型心肌梗死患者共32例（NSTEMI组），急性ST段抬高型心肌梗死患者29例（STEMI组）。另选同期年龄、性别相匹的正常体检者共35例（正常对照组）。检测PTX-3、hs-CRP水平，并随访1年主要心血管事件（MACE）的发生情况。结果与对照组比较，UAP组、NSTEMI组和STEMI组患者PTX-3、hs-CRP水平升高，差异具有统计学意义（P均＜0.05）。对97例ACS患者随访1年MACE的发生情况，33例发生MACE。通过ROC曲线计算血浆PTX-3、hs-CRP预测ACS患者发生MACE的最佳界值（cut off value）分别为PTX-3=6.05μg/L，hs-CRP=8.21 mg/L，ROC曲线下面积为0.78、0.58。结论 PTX-3水平能够预测ACS患者MACE发生情况。

Objective To discuss the changes of serum pentraxins （PTX-3） and high-sensitivity C-reactive protein （hs-CRP）, and correlation between them and prognosis in patients with acute coronary syndrome （ACS）. Methods The patients （n=132, male 81, female 51, aged from 40 to 75） were divided into stable angina pectoris group （SAP group,n=35）, unstable AP group （UAP group,n=36）, non- ST-segment elevation myocardial infarction （NSTEMI group,n=32） and STEMI group （n=29）, and other 35 cases of normal physical examinations with same age and sex were chosen as control group. The levels of PTX-3 and hs-CRP were detected, and all patients were followed up for 1 y for observing major adverse cardiovascular events （MACE）.Results Compared with control group, the levels of PTX-3 and hs-CRP increased in UAP group, NSTEMI group STEMI group （allP〈0.05）. There were 33 cases had MACE after followed up for 1 y in 97 ACS patients. The cut-off value of PTX-3 or hs-CRP for predicting MACE calculated with ROC curve was, respectively, PTX-3=6.05μg/L and hs-CRP=8.21 mg/L, and area under ROC curve was, respectively, 0.78 and 0.58.Conclusion The level of PTX-3 can predict the incidence of MACE in ACS patients.