CAJ | 학술논문

目的观察高敏C反应蛋白(hs-CRP)联合高敏心肌肌钙蛋白T(hs-cTnT)对急性冠状动脉综合征(ACS)患者预后的判断价值.方法选择2011年7月至2012年12月诊断为ACS的患者118例,根据临床表现分为3组:不稳定型心绞痛(UAP)组38例、非ST段抬高型心肌梗死(NSTEMI)组38例,ST段抬高型心肌梗死(STEMI)组42例.对入选患者进行为期3个月的随访,观察各组心血管事件及心源性死亡的发生情况.另选择20例门诊健康体检者作为对照组.结果 UAP组、STEMI组和NSTEMI组入院时血清hs-CRP含量均高于对照组,其中NSTEMI组升高最为明显,显著高于STEMI组和UAP组,差异均有统计学意义(P＜0.05).血清hs-cTnI含量在STEMI组和NSTEMI组均升高,且STEMI组升高程度高于NSTEMI组,差异均有统计学意义(P＜0.05).UAP组、NSTEMI组和STEMI组入院时血清hs-CRP含量≥3 mg/L患者出院后3个月内心血管事件及心源性死亡总发生率分别为6/11,40.0％(12/30),46.4％(13/28),明显高于血清hs-CRP含量＜3 mg/L患者的11.1％(3/27),3/8,5/14,差异有统计学意义(P＜ 0.05);NSTEMI组和STEMI组入院时血清hs-cTnT含量≥1.0 μg/L的患者出院后3个月内心血管事件及心源性死亡总发生率分别为16.7％(5/30),18.4％(7/38),明显高于血清hs-cTnT含量＜1.0 μg/L患者的1/8,1/4,差异有统计学意义(P＜0.05).结论血清hs-CRP含量显著升高是ACS患者不良预后的重要预测指标,联合hs-cTnT的升高有助于早期鉴别高危患者.对这类患者及时给予强化治疗及出院后密切监测,可减少心血管事件的发生.
목적 관찰고민C반응단백(hs-CRP)연합고민심기기개단백T(hs-cTnT)대급성관상동맥종합정(ACS)환자예후적판단개치.방법 선택2011년7월지2012년12월진단위ACS적환자118례,근거림상표현분위3조:불은정형심교통(UAP)조38례、비ST단태고형심기경사(NSTEMI)조38례,ST단태고형심기경사(STEMI)조42례.대입선환자진행위기3개월적수방,관찰각조심혈관사건급심원성사망적발생정황.령선택20례문진건강체검자작위대조조.결과 UAP조、STEMI조화NSTEMI조입원시혈청hs-CRP함량균고우대조조,기중NSTEMI조승고최위명현,현저고우STEMI조화UAP조,차이균유통계학의의(P＜0.05).혈청hs-cTnI함량재STEMI조화NSTEMI조균승고,차STEMI조승고정도고우NSTEMI조,차이균유통계학의의(P＜0.05).UAP조、NSTEMI조화STEMI조입원시혈청hs-CRP함량≥3 mg/L환자출원후3개월내심혈관사건급심원성사망총발생솔분별위6/11,40.0％(12/30),46.4％(13/28),명현고우혈청hs-CRP함량＜3 mg/L환자적11.1％(3/27),3/8,5/14,차이유통계학의의(P＜ 0.05);NSTEMI조화STEMI조입원시혈청hs-cTnT함량≥1.0 μg/L적환자출원후3개월내심혈관사건급심원성사망총발생솔분별위16.7％(5/30),18.4％(7/38),명현고우혈청hs-cTnT함량＜1.0 μg/L환자적1/8,1/4,차이유통계학의의(P＜0.05).결론 혈청hs-CRP함량현저승고시ACS환자불량예후적중요예측지표,연합hs-cTnT적승고유조우조기감별고위환자.대저류환자급시급여강화치료급출원후밀절감측,가감소심혈관사건적발생.
Objective To investigate the value of high-sensitivity C-reactive protein (hs-CRP) combined with high-sensitivity cardiac troponin T (hs-cTnT) for prognosis of patients with acute coronary syndrome (ACS).Methods One hundred and eighteen patients with ACS were selected from July 2011 to December 2012.According to the clinical feature,they were divided into unstable angina pectoris (UAP) group (38 cases),non ST segment elevation myocardial infarction (NSTEMI) group (38 cases) and ST segment elevation myocardial infarction (STEMI) group(42 cases).They were followed up for 3 months,and the incidence of cardiovascular events and cardiac death was observed.Twenty healthy people were selected as control group.Results The serum level of hs-CRP on admission in UAP group,STEMI group,NSTEMI group was higher than that in control group,and NSTEMI group was highest.And there was significant difference between NSTEMI group and STEMI group,and also between NSTEMI group and control group (P ＜ 0.05).The serum level of hs-cTnI was increased in STEMI group and NSTEMI group.The increased degree in STEMI group was higher than that in NSTEMI group,and there was significant difference (P ＜0.05).The incidence of cardiovascular events and cardiac death within 3 months after discharge in patients with the serum level of hs-CRP ≥ 3 mg/L on admission in UAP group and NSTEMI group,STEMI group was 6/11,40.0％ (12/30),46.4％ (13/28),which was higher than that in patients with the serum level of hs-CRP ＜ 3 mg/L[11.1％(3/27),3/8,5/14],and there was significant difference(P＜ 0.05).The incidence of cardiovascular events and cardiac death within 3 months after discharge in patients with the serum level of hs-cTnT≥ 1.0 μ g/L on admission in NSTEMI group and STEMI group was 16.7％(5/30) and 18.4％(7/38),which was higher than that in patients with the serum level of hs-cTnT ＜ 1.0 μ g/L (1/8,1/4),and there was significant difference (P ＜ 0.05).Conclusion Significantly increased hs-CRP is an important predictor of poor prognosis of ACS patients.hs-CRP combined with hs-cTnT is helpful in early identification of high-risk patients.Giving intensive treatment to these patients in time and monitoring closely after discharge can reduce the happening of cardiovascular events.