目的:探讨髓过氧化物酶(MPO)浓度与急性冠状动脉综合征(ACS)的关系及其早期识别ACS的临床价值。方法:采用酶联免疫吸附法测定血浆MPO浓度。结果:ACS组患者血浆MPO浓度明显升高,与正常对照组、稳定型心绞痛(SAP)组比较差异有统计学意义(P<0.05)。SAP组血浆MPO浓度高于正常对照组(P<0.05)。血浆MPO浓度与中性粒细胞、肌酸激酶同工酶及受试组呈正相关,与年龄、高敏感C反应蛋白、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、三酰甘油、天冬氨酸氨基转移酶、空腹血糖、乳酸脱氢酶、红细胞计数、血小板计数无相关性。依据临床表现和冠状动脉造影,临床诊断ACS 41例,非ACS组37例,绘制ROC曲线(A=0.927,P=0.000)。MPO诊断界值为212.59μg/L,MPO≥212.59μg/L为阳性,诊断为ACS,MPO<212.59μg/L为阴性,诊断非ACS。临床诊断ACS 41例中,MPO阳性39例,阴性2例,非ACS组37例中,MPO阳性5例,阴性32例,MPO诊断ACS灵敏度为95%,特异度为86%,准确度为91%,假阴性率(漏诊率)为5%,假阳性率(误诊率)为14%,阳性预测值为89%,阴性预测值为94%。本法与临床诊断ACS方法进行Kappa一致性检验,Kappa系数值为0.819,P=0.000,说明两种方法的吻合程度具有统计学意义,两法一致性较好。采用Logistic逐步回归,筛选出有统计学意义的影响因素为MPO、低密度脂蛋白胆固醇和肌酸激酶同工酶,建立预测模型,MPO预测ACS总正确率为95%,提示MPO对ACS具有较高的预测价值。结论:MPO能有效地早期识别ACS。 Objective: To investigate the relationship between the concentration of myeloperoxidase (MPO) and acute coronary syndrome (ACS) and its clinical value in early recognition of ACS. Methods: Plasma MPO concentration was determined by enzyme-linked immunosorbent assay. Results: The concentration of MPO in ACS group was significantly higher than that in normal control group and SAP group (P <0.05). The plasma MPO concentration in SAP group was higher than that in normal control group (P <0.05). Plasma MPO concentration and neutrophil, creatine kinase isoenzyme and the test group was positively correlated with age, high sensitivity C-reactive protein, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, Aspartate aminotransferase, fasting blood glucose, lactate dehydrogenase, erythrocyte count, platelet count no correlation. According to clinical manifestations and coronary angiography, 41 cases were diagnosed by ACS and 37 cases by non-ACS. The ROC curve was drawn (A = 0.927, P = 0.000). The cutoff value of MPO was 212.59μg / L, the MPO≥212.59μg / L was positive, the diagnosis was ACS, MPO <212.59μg / L was negative, and the diagnosis was non-ACS. Clinical diagnosis of ACS in 41 cases, MPO positive in 39 cases, negative in 2 cases, non-ACS group 37 cases, MPO positive in 5 cases, negative in 32 cases, MPO diagnosis of ACS sensitivity was 95%, specificity was 86%, accuracy 91 %, False negative rate (misdiagnosis rate) was 5%, false positive rate (misdiagnosis rate) was 14%, positive predictive value was 89%, negative predictive value was 94%. Kappa consistency test between this method and the clinical diagnosis of ACS method, Kappa coefficient of 0.819, P = 0.000, indicating that the two methods of anastomosis was statistically significant, the consistency of the two methods is better. Logistic stepwise regression was used to select statistically significant influencing factors as MPO, LDL-C and creatine kinase isoenzyme. The prediction model was established. The accuracy of MPO predicting ACS was 95% High predictive value. Conclusion: MPO can effectively identify ACS early.