【摘要】 目的探讨血清炎性标志物与急性冠脉综合征(ACS)的关系。方法检测48例ACS患者血清C-反应蛋白(CRP)、可溶性血管内皮细胞黏附分子-1(sVCAM-1)和可溶性细胞间黏附分子-1(sICAM-1)等炎性因子变化,与冠脉造影结果和临床预后进行对比分析。结果1ACS组血清CRP与sICAM-1、sVCAM-1水平均高于稳定性心绞痛(SA)组和正常对照组;2sVCAM-1≥870ng/ml者3个月内主要冠脉不良事件(MACE)发生率明显高于<870ng/ml者;3血清肌钙蛋白阳性者CRP、sICAM-1、sVCAM-1浓度均明显高于阴性者;4冠脉狭窄程度在ACS组与SA组无统计学差异;冠脉狭窄程度积分与TC水平呈正相关,而与血清CRP、sICAM-1、sV-CAM-1及血浆纤维蛋白原(Fig)水平均无相关性;5sVCAM-1、Fig和肌钙蛋白预测3个月内MACE发生的敏感性分别为67.5%、82.4%、57.1%;特异性分别为54.8%、58.1%、81.5%。结论血清炎性标志物对ACS患者临床危险分层和判断预后有重要意义。更多还原

【Abstract】 Objective To explore the relationship between inflammatory mediators and acute coronary syndrome(ACS).Methods Serum levels of C-reactive protein(CRP) and soluble intercellular adhesion molecule -1(sICAM-1),soluble vascular cell adhesion molecule -1(sVCAM-1) were measured in 48 patients with ACS.Coronary angiogrography was performed in all patients.Results ①Serum levels of sVCAM-1,sICAM-1 and CRP were significantly higher in patients with ACS than those in patients with SA and normal controls.②The incidence of MACE was higher in patients with serum sVCAM-1 ≥870ng/ml than those with serum sVCAM-1 < 870ng/ml.③Serum levels of sVCAM-1,sICAM-1 and CRP in patients with cTnT-positive were significantly higher than in patients with cTnT-negative.④The severity of coronary stenosis was not different in patients with ACS and those with SA.There was no correlationship between Gensini’s score of coronary stenosis and serum levels of inflammatory mediators,but there was a positive correlation to the serum TC concentration.⑤The sensitivity and specificity of predication for incidence of MACE following three months,sVCAM-1,Fig and cTnT were respectively 67.5%,82.4%,57.1% and 54.8%,58.1%,81.5%.Conclusion There is an important value of inflammatory markers for clinical risk stratification and prognosis dicision in patients with ACS.更多还原