急性冠脉综合征患者血清cTnI、hs-CRP、BNP与D-二聚体的变化

Changes of Serum cTnI, hs-CRP, BNP and D-dimer in Patients with Acute Coronary Syndrome

目的分析急性冠脉综合征(ACS)患者血清心脏肌钙蛋白I(cTnI)、超敏C反应蛋白(hs-CRP)、脑钠尿肽(BNP)与D-二聚体的变化,旨在为完善ACS的临床诊疗方案提供可靠的参考。方法回顾性分析2017年8月—2018年8月该院98例ACS患者的临床资料,并将其作为研究组。选择同期于该院进行体检的98名健康受检者作为对照组。两组患者均进行血清cTnI、hs-CRP、BNP与D-二聚体检测。比较两组患者的血清cTnI、hs-CRP、BNP与D-二聚体指标,比较不同病变支数ACS患者的血清cTnI、hs-CRP、BNP与D-二聚体指标。结果研究组血清cTnI(3.72±0.25)μg/L、hs-CRP(10.52±5.32)mg/L、BNP(356.50±25.20)ng/L与D-二聚体(405.50±28.05)μg/L均高于对照组(0.03±0.01)μg/L、(1.75±1.85)mg/L、(65.65±18.60)ng/L与(240.52±10.52)μg/L(t=10.523,12.856,16.523,20.523,P<0.01)。研究组ACS患者病变的血管支数越多,其血清cTnI、hs-CRP、BNP与D-二聚体指标越高,即3支及以上病变血清cTnI(5.88±4.02)μg/L、hs-CRP(13.65±8.36)mg/L、BNP(412.52±228.65)ng/L与D-二聚体(502.52±180.65)μg/L>双支病变(0.83±0.75)μg/L、(10.12±8.20)mg/L、(315.52±15.05)ng/L与(426.52±168.44)μg/L(P<0.05)>单支病变(0.18±0.05)μg/L、(7.25±6.52)mg/L、(245.65±122.52)ng/L与(310.52±105.65)μg/L(P<0.05)(F=4.656,4.898,5.053,5.263,P<0.05)。结论血清cTnI、hs-CRP、BNP与D-二聚体在ACS患者诊断与病情程度评估中具有重要的应用意义,值得临床推广。

Objective To analyze serum cardiac troponin I (cTnI), hypersensitive C-reactive protein (hs-CRP), brain natriuretic peptide (BNP) and D-dimer in patients with acute coronary syndrome (ACS), to provide a reliable reference for improving the clinical diagnosis and treatment of ACS. Methods The clinical data of 98 patients with ACS in our hospital from August 2017 to August 2018 were retrospectively analyzed and used as the study group. 98 healthy subjects who underwent physical examination in our hospital at the same time were selected as the control group. Serum cTnI, hs-CRP, BNP and D-dimer were detected in both groups. Serum cTnI, hs-CRP, BNP and D-dimer were compared between the two groups. Serum cTnI, hs-CRP, BNP and D-dimer were compared between ACS patients with different lesion counts. Results Serum cTnI (3.72±0.25)μg/L, hs-CRP (10.52±5.32)mg/L, BNP (356.50±25.20)ng/L and D-dimer (405.50±28.05)μg/L, higher than the control group (0.03±0.01)μg/L,(1.75±1.85)mg/L,(65.65±18.60)ng/L and (240.52±10.52)μg/L (t=10.523, 12.856, 16.523, 20.523, P<0.01). The more vascular counts in the study group, the higher the serum cTnI, hs-CRP, BNP and D-dimer index, ie the serum cTnI (5.88±4.02)μg/L, hs- CRP (13.65±8.36)mg/L, BNP (412.52±228.65)ng/L and D-dimer (502.52±180.65)μg/L> double-vessel disease (0.83±0.75)μg/L,(10.12±8.20)mg/L,(315.52 ± 15.05)ng/L and (426.52 ± 168.44)μg/L(P<0.05)> single-vessel disease (0.18 ± 0.05)μg/L,(7.25±6.52)mg/L,( 245.65±122.52)ng/L and (310.52±105.65)μg/L(P<0.05)(F= 4.656, 4.898, 5.053, 5.263, P<0.05). Conclusion Serum cTnI, hs-CRP, BNP and D-dimer have important application significance in the diagnosis and severity assessment of ACS patients, which is worthy of clinical promotion.