急性冠状动脉综合征病人血清中超敏肌钙蛋白、超敏C反应蛋白和同型半胱氨酸水平变化及临床意义

Serum levels of hypersensitive troponin T,hypersensitive C-reactive protein and homocysteine in patients with acute coronary syndrome,and its clinical significance

目的:探讨急性冠状动脉综合征(ACS)病人血清超敏肌钙蛋白T(hs-cTnT)、超敏C反应蛋白(hs-CRP)及同型半胱氨酸(HCY)与冠状动脉病变程度的关系及临床意义。方法:随机选择120例ACS病人作为观察组,其中不稳定型心绞痛(UAP)组60例,急性心肌梗死(AMI)组60例,并选择同期体检健康者60名作为对照组。所有病人入院后24 h内进行血清hs-cTnT、hs-CRP和HCY检测并与对照组比较;分析hs-cTnT、hs-CRP和HCY水平与不同冠状动脉病变程度的关系。结果:3组研究对象血清hs-cTnT、hs-CRP和HCY水平差异有统计学意义(P<0.01),以上3个指标AMI组均明显高于UAP组和对照组(P<0.01),且UAP组明显高于对照组(P<0.01)。冠状动脉不同病变程度组之间比较发现,随着病变程度加重,hs-cTnT、hs-CRP和HCY水平逐渐升高(P<0.01)。hs-cTnT和hs-CRP呈正相关关系(r=0.525,P<0.01);hs-cTnT和HCY呈正相关关系(r=0.742,P<0.01);hs-CRP和HCY呈正相关关系(r=0.461,P<0.01)结论:hs-cTnT、hs-CRP和HCY水平对ACS病人的临床诊断有一定价值,对冠状动脉病变程度及范围具有临床指导意义,值得临床推广应用。

Objective:To explore the relationships between the serum levels of hypersensitive troponin T(hs-cTnT),hypersensitive C-reactive protein(hs-CRP),homocysteine(Acy)and degree of coronary artery disease in patients with acute coronary syndrome(ACS).Methods:One hundred and twenty patients with ACS were set as the observation group,which included the unstable angina pectoris group(UAP group,60 cases)and acute myocardial infarction(AMI group,60 cases),and 60 physical examiners were set as the control group at the same time.The serum levels of hs-cTnT,hs-CRP and HCY in observation group were detected after 24 h of admission,and compared with the control group.The correlations of serum levels of hs-cTnT,hs-CRP and HCY with degrees of coronary artery disease were analyzed.Results:The differences of the serum levels of hs-cTnT,hs-CRP and HCY among three groups were statistically significant(P<0.01),the above three indexes in AMI group were significantly higher than those in UAP group and control group(P<0.01),and the above three indexes in UAP group were significantly higher than those in control group(P<0.01).With the disease degree aggravating,the serum levels of hs-cTnT,hs-CRP and HCY increased gradually,and the difference of which was statistically significant(P<0.01).The level of hs-cTnT was positively correlated with that of hs-CRP(P<0.01),the level of hs-cTnT was positively correlated with that of HCY(P<0.01),and the level of hs-CRP was positively correlated with that of HCY(P<0.01).Conclusions:The serum levels of hs-cTnT,hs-CRP and HCY have certain value in the clinical diagnosis of ACS,and clinical guiding significance in identifying the degree and range of coronary artery lesions,which is worthy of clinical promotion and application.