急性冠状动脉综合征患者炎症标记物水平的变化及临床意义

Changes and clinical significance of inflammation in acute coronary syndrome

目的 :通过观察C -反应蛋白及纤维蛋白原的水平变化 ,探讨炎症标记物在急性冠状动脉综合征中的关系及临床意义。方法 :急性冠状动脉综合征 (ACS)组 10 2例 ,其中急性心肌梗死 (AMI)亚组 34例 ,不稳定性心绞痛 (UAP)亚组 6 8例 ,选择稳定性心绞痛 (SAP) 4 4例作对照组。分别采用速率散射比浊法及热沉淀比浊法测定血清C -反应蛋白 (CRP)及纤维蛋白原 (FIB)。结果 :ACS组CRP高于SAP组 (19.2 3± 18.2 6mg/Lvs 1.72± 0 .82mg/L ,P <0 .0 5 ) ,AMI亚组明显高于UAP亚组与SAP组(2 6 .34± 2 5 .38mg/Lvs 12 .0 7± 10 .85mg/L、1.72± 0 .82mg/L ,P <0 .0 1) ,UAP亚组高于SAP组 (12 .0 7±10 .85mg/Lvs 1.72± 0 .82mg/L ,P <0 .0 5 )。ACS组FIB高于SAP组 (3.5 3± 1.2 9g/Lvs 2 .2 4± 4 .81g/L ,P<0 .0 5 ) ,AMI亚组明显高于UAP亚组与SAP组 (3.87± 1.5 0g/Lvs 3.4 7± 1.0 8g/L、2 .2 4± 4 .81g/L ,P<0 .0 1) ,UAP亚组高于SAP组 (3.4 7± 1.0 8g/L、2 .2 4± 4 .81g/L ,P <0 .0 5 )。结论 :炎症参与了ACS患者的发病过程 ,血清中炎症因子水平的高低与冠心病病情严重程度有关。ACS患者CRP和FIB水平增高 ,二者均是ACS发生的独立危险因素。

Objective: To investigate the relation of inflammation markers to acute coronary syndrome(ACS) and the clinical significance by observing the changes of C-reactive protein(CRP) and fibrinogen(FIB). Methods: The ACS group included 102 patients, which were composed of the acute myocardial infarction(AMI) subgroup (34 patients) and the unstable angina pectoris(UAP) subgroup(68 patients), the control group were 44 patients with stable angina pectoris(SAP). All of them were measured serum CRP and FIB . Results: Serum CRP was higher in ACS group compared with SAP group(19.23±18.26mg/L vs 1.72±0.82mg/L,P<0.05),which of AMI subgroup was much higher than UAP subgroup and SAP group(26.34±25.38mg/L vs 12.07±10.85mg/L 、1.72±0.82mg/L,P<0.01),of UAP subgroup was higher than SAP group(12.07±10.85mg/L vs 1.72±0.82mg/L,P<0.05).FIB was higher in ACS group compared with SAP group(3.53±1.29g/L vs 2.24±4.81g/L,P<0.05),which of AMI subgroup was much higher than UAP subgroup and SAP group(3.87±1.50g/L vs 3.47±1.08g/L 、2.24±4.81g/L,P<0.01),of UAP subgroup was higher than SAP group(3.47±1.08g/L 、2.24±4.81g/L,P<0.05). Conclusion: Inflammation takes part in the course of ACS. The levels of inflammation factors in serum are related to the seriousness of CHD. The serum CRP and FIB were increased in ACS. There were independent risk factors of ACS.