摘要
目的:探讨C反应蛋白(CRP)对不稳定型心绞痛(UA)危险分层的临床价值。方法:对109例UA患者入院时分别测定CRP、心脏肌钙蛋白T(cTNT)、肌酸磷酸激酶同工酶(CK-MB),随访三个月,观察终点为急性心肌梗死(AMI)和心源性猝死。结果:在109例UA患者中,CRP升高37例(34.2％),正常72例(66.1％),三个月中发生急性心肌梗死10例,心源性猝死5例,冠状动脉咸形术(PTCA)15例,冠脉搭桥术(CABG)6例。其中CRP升高组AMI的发生率明显高于正常组(P<0.01),但死亡率无明显差别。CRP的敏感度(83.33％)较TNT、CK-MB增高。多因素Logistic回归分析CRP升高、cTNT升高、陈旧性心梗和胸痛次数是预测近期AMI、心源性猝死的独立危险因素。结论:CRP对UA患者的近期预后和早期治疗有重要的临床价值,是危险分层的良好指标之一。
To evaluate the value of C-reactive protein (CRP) in the risk stratification in unstable angina. Methods: 109 patients with unstable angina were chosen and followed up 3 months. Everyone were measured with CRP,cTNT,CK-MB. The end point was cardiac events including acute infarction (AMI) and cardiac death. Results: In 109 patients with UA, 37 cases (34.2%) had elevated CRP level, 10 cases had AMI, 5 cases died of cardiac events. The rate of AMI was higher in patients with increased CRP (P< 0.01). But there was no difference between two groups in the death rate. The sensitivity of CRP for predicting cardiac events (83. 33% ) is greater than TNT and CK-MB and the specificity was 72.16% . Conclusions: CRP has practical significance in evaluating the short-term outcome and earlier treatment of unstable angina. It could be used as a marker for the risk stratification of UA.
