急性冠脉综合征患者血清胱抑素C与高敏C反应蛋白水平变化及意义

Changes in levels of high-sensitivity C-reactive protein and serum cystatin C in patients with acute coronary syndrome

目的观察急性冠脉综合征(ACS)患者血清胱抑素C(Cys C)与高敏C反应蛋白(hs-CRP)水平的变化,并探讨其临床意义。方法将147例冠脉造影确诊的ACS患者作为病例组[不稳定型心绞痛(UAP)48例、ST段抬高型心肌梗死(STEMI)51例、非ST段抬高型心肌梗死(NSTEMI)48例〗,同时将50例同期冠脉造影检查阴性者作为对照组。检测患者血清Cys C和hs-CRP水平,观察两者与冠状动脉Gensini积分及ACS的关系。结果 UAP组[(1.13±0.25)mg/L]、STEMI组[(1.22±0.20)mg/L]、NSTEMI组[(1.32±0.31)mg/L]患者血清Cys C水平均高于对照组[(0.96±0.23)mg/L],P均<0.05。UAP组[(14.18±3.02)mg/L]、STEMI组[(22.31±5.13)mg/L]、NSTEMI组[(17.55±4.39)mg/L]患者血清hs-CRP水平均高于对照组[(3.92±1.34)mg/L],P均<0.05。UAP组、STEMI组和NSTEMI组患者血清Cys C水平与冠状动脉Gensini积分均呈正相关(r分别为0.625、0.681、0.750,P均<0.05),血清hs-CRP水平与冠状动脉Gensini积分均呈正相关(r分别为0.524、0.670、0.513,P均<0.05)。ACS患者高Cys C、高hs-CRP水平的OR分别为6.02、8.43,P均<0.05。结论 ACS患者血清Cys C、hs-CRP水平升高,血清Cys C、hs-CRP水平与冠状动脉狭窄程度有关,血清Cys C、hs-CRP水平升高均是ACS的危险因素。

Objective To observe the changes in levels of high-sensitivity C-reactive protein（ hs-CRP） and serum cystatin C（ Cys C） in patients with acute coronary syndrome（ ACS） and to investigate the clinical significance. Methods A total of 147 patients with ACS examined by coronary angiography（ CAG） were selected and further divided into the unstable angina pectoris group（ UAP group,n = 48）,ST segment elevated myocardial infarction group（ STEMI group,n = 51） and nonST segment elevated myocardial infarction（ NSTEMI group,n = 48）. Fifty subjects whose CAG results were negative in the same period were recruited into the control group. The levels of serum Cys C and hs-CRP were detected,and the relationships of patients with coronary artery Gensini scores and ACS were observed. Results The levels of serum Cys C in the UAP group[（ 1. 13 ±0. 25） mg/L],STEMI group [（ 1. 22 ±0. 20） mg/L]and NSTEMI group [（ 1. 32 ±0. 31） mg/L]were all higher than that in the control group [（ 0. 96 ± 0. 23） mg / L]（ all P〈0. 05）. The levels of serum hs-CRP in the UAP group[（ 14. 18 ±3. 02） mg/L],STEMI group [（ 22. 31 ± 5. 13） mg/L]and NSTEMI group [（ 17. 55 ± 4. 39） mg/L]were all higher than that in the control group [（ 3. 92 ± 1. 34） mg / L]（ all P〈0. 05）. The levels of serum Cys C of the UAP group,STEMI group and NSTEMI group were positively correlated with coronary artery Gensini scores（ r = 0. 625,0. 681 and 0. 750,respectively; all P〈0. 05）. The levels of serum hs-CRP of the UAP group,STEMI group and NSTEMI group were positively correlated with coronary artery Gensini scores（ r = 0. 524,0. 670 and 0. 513,respectively; all P〈0. 05）. The high level of serum Cys C and high level of hs-CRP were risk factors for ACS（ OR = 6. 02 and 8. 43,respectively; all P〈0. 05）. Conclusions The levels of serum Cys C and hs-CRP were increased in ACS patients and they were related with coronary stenosis of ACS. The high levels of serum Cys C and hs-CRP were risk factors for ACS.