【摘要】 目的探讨血浆炎症标志物C-反应蛋白水平与急性冠脉综合征(ACS)的相关性以及与近期预后的关系。方法测定120例ACS患者和94例健康对照组的血浆CRP水平,随访ACS患者住院期间、30天以及3个月死亡事件以及MACE发生率。结果(1)120例ACS患者中AMI组35例,UAP组85例,血浆CRP水平分别为17.81±10.4 mg/L和10.64±6.58 mg/L,与对照组CRP水平4.52±1.20 mg/L相比均明显升高,P<0.05,而且AMI组和UAP组之间的CRP水平也有差异,AMI组高于UAP组,P<0.05。(2)根据血浆CRP水平将120例ACS患者分为三组:CRP≤8.0 mg/L组,8.1-24.0 mg/L组,>24.0 mg/L组。随着血浆CRP水平的升高,各组的死亡率和MACE发生率也呈现增高趋势。在多变量的Logistic回归分析中,CPR独立于年龄、性别、吸烟、高脂血症、高血压、糖尿病等冠心病危险因素,预测30天死亡率OR=3.33,95%CI 1.71-12.46,3个月死亡率OR=3.08,95%CI 1.57-10.89,P<0.05;预测30天MACE发生率,OR=1.29,95%CI 1.11-6.01,3个月MACE发生率,OR=1.14,95%CI 1.09-5.27,P<0.05。结论血浆CRP水平与ACS密切相关,ACS病情越严重CRP水平越高。而且CRP水平和ACS患者的临床事件的发生率密切相关,可预测短期的病死率和MACE发生率,对判断ACS患者的近期预后有重要的参考价值。更多还原

【Abstract】 Objective To evaluate the prognostic value of plasma C-reactive protein(CRP) in patients with acute coronary syndromes(ACS).Methods 120 patients with ACS and 94 healthy people were adopted in the study.Plasma CRP were measured and the risk for major adverse cardiac events(MACE) at 30 days and 3 months were analyzed.Results CRP levels were 17.81±10.4 mg/L,10.64±6.58 mg/L and 4.52±1.20 mg/L in AMI,UAP and control groups respectively,CRP levels were higher in AMI and UAP groups than in controls.CRP levels were different between AMI and UAP groups too.According to the CRP levels,patients were divided into 3 groups(CRP≤8.0 mg/L,8.1-24.0 mg/L and 24.0 mg/L).Mortality and MACE incidence increased significantly in the patients with high CRP levels.Multivariate logistic regression analyses showed that plasma CRP level predicted 30-day and 3-month mortality and MACE incidence independent of age,gender,hypertension,smoking,hyperlipimia and diabetes.Conclusion Plasma CRP levels increased in the patients with ACS and related to the severity of symptoms.Plasma CRP is a good predictor for mortality and MACE incidence in ACS patients.更多还原