【摘要】 目的:探讨血清淀粉样蛋白A(SAA)与冠心病(CHD)发生、病变程度及预后的关系。方法:分析88例CHD和92例对照者临床资料并测定高敏C反应蛋白(hsCRP)和SAA。结果:急性冠状动脉综合征(ACS)患者血清SAA及hsCRP水平高于稳定型心绞痛(SAP)组和对照组(P<0.01),SAA水平与hsCRP水平呈正相关(r=0.807,P<0.01);在Gensini积分位于20～40分及大于40分2组的SAA和hsCRP明显高于Gensini积分小于20分的亚组(P<0.01),但与病变范围无关。以SAA≥4.80mg/L或hsCRP≥3.73mg/L作为异常增高上限,对CHD临床识别的敏感性SAA(80.7%)优于hsCRP(61.4%)。SAA水平增高组血管重建的发生率高于SAA水平正常组,差异有统计学意义(P<0.05)。比较CHD危险因素导致CHD发生的危害性,结果显示:SAA>TC>高血压史>吸烟>年龄。结论:炎症反应贯穿于CHD的发生发展,SAA和hsCRP对冠状动脉病变的严重程度有一定的预测价值。SAA对CHD临床识别的敏感性较高,对于及时发现高危人群具有一定的临床意义,SAA在判断CHD的预后方面可能有一定的临床意义。更多还原

【Abstract】 Objective:To study the relationship between plasma levels of serum amyloid A protein(SAA) concentrations and clinical course(including prognosis) in patients with CHD.Method:88 patients with CHD and 92 controls were enrolled.The clinical data were obtained,and the plasma concentration of hsCRP and SAA were measured.Result:The concentration of SAA is highly correlated with hs-CRP(r=0.807,P<0.01).We demonstrated that the concentration of SAA and hs-CRP were significantly higher in group of ACS than in group of SAP and control subjects(P<0.01).There is significant difference between the Gensini score of 20-40(or>40) and Gensini score <20,but there is no relationship with lesions area.We demonstrated that the incidence of CHD is higher with the concentration of SAA≥4.80 mg/L or hs-CRP ≥3.73 mg/L than lower,and the sensitivity are 80.7%(SAA) and 61.4%(hsCRP).There is significant difference in prognisis of revascularization between two SAA groups(P<0.05).The relative importance comparison study among risk factors of CHD: SAA>TC>the history of hypertension>smoking>age.Conclusion:Inflammation is associated with coronary artery disease progression.SAA may have a potential role in predicting the severity of CHD with high sensitivity.SAA may predict the prognosis of CHD in many aspecters.更多还原