【摘要】 目的:探讨超敏C-反应蛋白(hs-CRP)、血脂水平与急性冠状动脉综合征(ACS)患者6个月内预后的关系。方法:分别测定201例非ST段抬高的ACS患者入院时的hs-CRP和血脂水平,随访6个月,终点为冠状动脉事件(冠心病性死亡、非致死性急性心肌梗死、急诊再血管化、因不稳定型心绞痛引起的再住院)。hs-CRP≥3mg/L、总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)≥4.7mmol/L为异常。结果:201例患者中发生冠心病猝死5例,非致死性心肌梗死16例,急诊再血管化4例,不稳定型心绞痛所致再住院27例。hs-CRP异常组较hs-CRP正常组冠状动脉事件发生率显著增高(RR1.90,95%CI1.09~3.32,P<0.05)。血脂异常组较正常组冠状动脉事件发生率亦显著增高(RR1.70,95%CI1.02~2.83,P<0.05)。血脂及hs-CRP均异常组较均正常组冠状动脉事件发生率显著升高(RR3.43,95%CI1.35~8.73,P<0.01)。结论:hs-CRP或(和)血脂水平异常的ACS患者6个月内冠状动脉事件发生率显著升高,并以二者均异常者为著,因此联合检测可能有助于识别冠心病二级预防中的高危个体。更多还原

【Abstract】 Objective:To evaluate the six-month prognostic value of the levels of high sensitive C-reactive protein (hs-CRP) and lipid in patients with acute coronary syndromes. Method:We measured the level of serum hs-CRP, total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)in 201 patients with Non-ST segment elevated acute coronary syndromes (ACS) and thereafter followed up six months. The endpoints were coronary events (Death from coronary heart disease, nonfatal acute myocardial infarction, emergency coronary revascularization, rehospitalization for unstable angina). Hs-CRP ≥3 mg/L or/and TC/HDL-C≥4.7 were considered to be abnormal. Result:The number of death from coronary heart diseases, nonfatal acute myocardial infarction, emergency coronary revascularization and rehospitalization for unstable angina was 5, 16, 4 and 27 respectively after six months of follow-up among the 201 patients. Compared with hs-CRP normal group, the incidence of coronary events in hs-CRP abnormal group significantly increased(RR 1.70,95% CI 1.02~2.83,P<0.05). Compared with lipid normal group, the incidence of coronary events also significantly increased (RR 3.43,95% CI 1.35~8.73,P<0.01).Compared with the group that hs-CRP and lipid are all normal, the incidence of coronary events in all abnormal group significantly increased(RR 3.43,95% CI 1.35~8.73,P<0.01). Conclusion:During six-month’s follow up, the incidence of coronary events was significantly higher in patients with ACS whose serum level of hs-CRP or lipid was abnormal, especially both were abnormal. To combine the measurement of hs-CRP and lipid may improve the accuracy in identifying the individuals with high risk of recurrent coronary events in secondary prevention of coronary heart disease.更多还原