【摘要】 目的探讨P-选择素、C-反应蛋白(CRP)和心肌肌钙蛋白I(cTnI)对急性冠状动脉综合征(ACS)患者短期预后评估的作用。方法分别测定70例ACS患者入院时外周血的P-选择素、CRP和cTnI水平。随诊1个月,终点为心脏事件。同时测定18例健康成人的P-选择素作对照。结果ACS组的P-选择素水平较对照组明显增高(P<0.01),在70例ACS患者中P-选择素升高27例,CPR升高23例,cTnI升高38例。随诊期共发生心脏事件14例,各因子增高组的心脏事件率均较正常组高(均为P<0.05)。其与ACS预后关系的相对危险度分别是5.74、6.83和3.94(均为P<0.05)。阳性预测值分别是37%、34%和28%。这三种因子的联合试验对心脏事件的阳性预测值是42.9%。结论P-选择素与ACS发生有关;P-选择素、CRP和cTnI分别与ACS短期预后有关,可作为危险分层的指标之一;联合检测意义更大。更多还原

【Abstract】 Objective To evaluate the prognostic values of P-selectin,C-reactive protein(CRP) and cardiac troponin I(cTnI)in patients with acute coronary syndrome(ACS).Methods The levels of P-selectin,CRP and cTnI in 70 patients with ACS were determined after hospitalization.Then the patients were followed up for a month.The end-point was cardiac events.Meanwhile,the levels of P-selectin of 18 healthy adults were measured as control group.Results The level of P-selectin was significantly higher in ACS group than in control group(P<0.01).Among 70 patients with ACS,27 cases had elevated P-selectin,23 had elevated CRP,and 38 had elevated cTnI.14 patients developed cardiac events.All the rates of cardiac events in each factor elevated group were higher than those in controls(P<0.05).The relative risk factor for the cardiac events according to the elevated P-selectin,CPR and cTnI were 5.74,6.83 and 3.94,respectively(P<0.05 for each).Accordingly,the positive predictive values of these factors for the cardiac events were 37%,34% and 28%,respectively.The positive predictive value of serial test of three factors to cardiac events was 42.9%.Conclusion P-selectin is associated with the pathogenesis of ACS; The levels of P-selectin,CRP and cTnI of patients with ACS are related to short-term prognosis,which can be used as the markers for risk stratification.Serial test of these factors may improve the predictive value.更多还原