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目的:探讨急性冠状动脉综合征(ACS)患者血清中高敏C反应蛋白(hs-CRP)、脑利钠肽(BNP)、D-二聚体的水平与近期不良心血管事件的关系,为临床诊治提供依据。方法:选择冠心病患者376例,均行冠状动脉造影检查,其中稳定型心绞痛(SAP)120例,不稳定型心绞痛(UAP)152例,非ST段抬高性心肌梗死(NSTEMI)30例及ST段抬高性心肌梗死(STEMI)74例。采用双抗夹心免疫荧光法检测BNP浓度;采用免疫比浊法测定hs-CRP、D-二聚体。出院后90d以电话、复查等手段随访本人或亲属,询问并记录不良心血管事件。结果:UAP、NSTEMI和STEMI外周血hs-CRP、BNP和D-二聚体水平依次升高,差异有统计学意义。同时3组不良心血管事件发生率UAP组最低(4.61%),NSTEMI组次之(16.67%),STEMI组最高(24.32%),其中UAP组和NSTEMI组、UAP组和STEMI组进行比较,差异有统计学意义;STEMI组不良事件发生率较NSTEMI组高,但差异无统计学意义。高血压病、hs-CRP、BNP、D-二聚体、LDL是ACS患者近期不良心血管事件的高危影响因素。结论:外周血hs-CRP、BNP、D-二聚体是反映ACS患者近期心血管事件的有效指标。
Objective: To investigate the relationship between serum hs-CRP, BNP and D-dimer levels and recent adverse cardiovascular events in patients with acute coronary syndrome (ACS) Diagnosis and treatment to provide the basis. Methods: A total of 376 patients with coronary heart disease were enrolled in this study. All patients underwent coronary angiography, including 120 cases of stable angina pectoris (SAP), 152 cases of unstable angina pectoris (UAP), 30 cases of non-ST elevation myocardial infarction (NSTEMI) ST - segment elevation myocardial infarction (STEMI) in 74 cases. The concentration of BNP was measured by double-antibody sandwich immunofluorescence method. The hs-CRP and D-dimer were measured by immunoturbidimetry. 90d after discharge by telephone, review and other means of follow-up or relatives, ask and record adverse cardiovascular events. Results: The levels of hs-CRP, BNP and D-dimer in peripheral blood of UAP, NSTEMI and STEMI were increased in turn, with statistical significance. The incidence of adverse cardiovascular events in the three groups was the lowest (4.61%) in UAP group, followed by NSTEMI group (16.67%) and highest in STEMI group (24.32%) in UAP group, NSTEMI group, UAP group and STEMI group The incidence of adverse events in STEMI group was higher than that in NSTEMI group, but the difference was not statistically significant. Hypertension, hs-CRP, BNP, D-dimer and LDL are risk factors for recent adverse cardiovascular events in patients with ACS. Conclusion: hs-CRP, BNP and D-dimer in peripheral blood are effective indicators of recent cardiovascular events in patients with ACS.