目的:探讨髓过氧化物酶(MPO)、心型脂肪酸结合蛋白(H-FABO)检测对非ST段抬高急性冠状动脉综合征(NSTE-ACS)危险分层的价值。方法:将2012-07-2015-07收治的247例NSTE-ACS患者作为NSTE-ACS组,同期在医院体检的健康人群75例作为对照组,NSTE-ACS患者分为NSTEMI组164例和UA组83例,按照冠状动脉狭窄程度分为轻度狭窄组113例、中度狭窄组55例和重度狭窄组79例,按照冠状动脉病变受累程度分为单支病变组85例、双支病变组69例和三支病变组93例,按照GRACE评分分为低危组118例、中危组92例和高危组37例;采用双抗体夹心法酶联免疫吸附试验检测各组血清H-FABO含量,酶联免疫吸附试验检测血清MPO、高敏C反应蛋白(hs-CRP)含量;NSTE-ACS患者随访12个月,记录6个月、12个月主要心脏不良事件(MACE)发生情况,通过绘制ROC曲线分析血清H-FABO、MPO对NSTE-ACS发生MACE的预测价值。结果:各组间性别、年龄比较差异无统计学意义(P>0.05),NSTE-ACS组血清H-FABO、MPO、hs-CRP均显著高于对照组(P<0.05),NSTEMI组血清H-FABO、MPO、hs-CRP显著高于UA组(P<0.05)。随着冠状动脉狭窄程度加重,血清H-FABO、MPO、hs-CRP逐渐升高,其中中度狭窄组、重度狭窄组血清H-FABO、MPO、hsCRP显著高于轻度狭窄组,重度狭窄组血清H-FABO、MPO、hs-CRP又显著高于中度狭窄组(P<0.05);随着冠状动脉病变受累程度加重,血清H-FABO、MPO、hs-CRP逐渐升高,其中双支病变组、三支病变组血清H-FABO、MPO、hs-CRP显著高于单支病变组,三支病变组血清H-FABO、MPO、hs-CRP又显著高于双支病变组(P<0.05);随着危险度级别升高,血清H-FABO、MPO、hs-CRP逐渐升高,中危组、高危组血清H-FABO、MPO、hsCRP显著高于低危组,高危组血清H-FABO、MPO、hs-CRP又显著高于中危组(P<0.05)。H-FABO预测6个月发生MACE的AUC为0.809,MPO预测6个月发生MACE的AUC为0.794,2种指标预测6个月发生MACE的AUC差异无统计学意义(Z=0.974,P=0.651);H-FABO预测12个月发生MACE的AUC为0.786,MPO预测12个月发生MACE的AUC为0.869,MPO预测12个月发生MACE的AUC显著高于H-FABO(Z=2.843,P=0.017)。结论:随着动脉狭窄程度加重、病变支数增多、危险度级别升高,血清H-FABO、MPO逐渐升高;H-FABO、MPO对近期发生MACE均具有良好的预测价值,MPO对远期发生MACE具有良好的预测价值。 Objective: To investigate the value of myeloperoxidase (MPO) and cardiac fatty acid binding protein (H-FABO) in risk stratification of non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods: Totally 247 patients with NSTE-ACS who were admitted from July 2012 to July15, 2007 were enrolled as NSTE-ACS group and 75 healthy subjects in the hospital were enrolled as control group. NSTE-ACS patients were divided into NSTEMI group (164 cases) and UA group 83 cases were divided into mild stenosis group (113 cases), moderate stenosis group (55 cases) and severe stenosis group (79 cases) according to the degree of coronary artery stenosis. According to the extent of coronary artery disease, 85 cases were classified as single vessel disease group and double vessel disease group 93 cases were divided into three groups according to the GRACE score: 118 cases in the low-risk group, 92 cases in the middle-risk group and 37 cases in the high-risk group. The serum H-FABO levels in each group were detected by double antibody sandwich enzyme-linked immunosorbent assay Serum MPO and high-sensitivity C-reactive protein (hs-CRP) levels were detected by enzyme linked immunosorbent assay (ELISA). The patients with NSTE-ACS were followed up for 12 months and recorded the major adverse cardiac events (MACEs) at 6 months and 12 months. Curve analysis of serum H-FABO, MPO NSTE-ACS occurred MACE predictive value. Results: There was no significant difference in gender and age among the groups (P> 0.05). The serum levels of H-FABO, MPO and hs-CRP in NSTE-ACS group were significantly higher than those in control group -FABO, MPO, hs-CRP were significantly higher than UA group (P <0.05). Serum levels of H-FABO, MPO and hs-CRP gradually increased with the severity of coronary artery stenosis. The levels of H-FABO, MPO and hsCRP in moderate and severe stenosis group were significantly higher than those in mild stenosis group and severe stenosis group Serum levels of H-FABO, MPO and hs-CRP were significantly higher than those of moderate stenosis group (P <0.05). With the severity of coronary artery disease, serum H-FABO, MPO and hs-CRP gradually increased, Serum levels of H-FABO, MPO and hs-CRP were significantly higher in the diseased group and the third diseased group than in the single lesion group. The levels of H-FABO, MPO and hs-CRP in the three lesion groups were significantly higher than those in the double vessel diseased group (P < 0.05). The levels of serum H-FABO, MPO and hs-CRP increased gradually with the increase of the degree of risk. The levels of serum H-FABO, MPO and hsCRP in middle-risk group and high-risk group were significantly higher than those in low risk group -FABO, MPO, hs-CRP were significantly higher than the medium risk group (P <0.05). H-FABO predicted AUC of MACE at 6 months was 0.809, MPO predicted AUC of MACE at 6 months was 0.794. There was no significant difference in AUC between MACE and MACE at 6 months (Z = 0.974, P = 0.651 ). The AUC of MACE predicted by H-FABO at 12 months was 0.786. The AUC of MACE predicted by MPO at 12 months was 0.869. The AUC of MACE predicted by MPO at 12 months was significantly higher than that of H-FABO (Z = 2.843, P = 0.017). Conclusions: With the increase of arterial stenosis, the number of lesion increased and the level of risk increased. The levels of H-FABO and MPO increased gradually. H-FABO and MPO had good predictive value for recent MACE. The occurrence of MACE has good predictive value.