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目的:观察冠心病不同类型患者中血清炎性递质C反应蛋白(CRP)、淀粉样蛋白A(SAA)和白细胞介素-6(IL-6)水平的变化以及炎症递质之间的关系,探讨急性冠状动脉综合征(ACS)预测的炎症指标。方法:用酶联免疫吸附法检测了32例急性心肌梗死,30例不稳定型心绞痛,20例稳定型心绞痛和16例健康对照者血清CRP、SAA、IL-6水平,并比较上述指标与不同类型冠心病,ACS与非ACS之间的关系。结果:ACS患者血清CRP、SAA和IL-6均高于非ACS患者,分别为(6.94±4.56)∶(2.48±2.32)mg/L;(217.23±441.14)∶(18.18±28.05)mg/L;(4.37±6.35)∶(1.31±0.98)ng/L(均P<0·01)。CRP、SAA和IL-6三者之间呈显著正相关。以CRP、SAA和IL-6的x-±2s为截断值联合预测ACS的灵敏度为73.8%,特异度为91.7%,准确性为80.4%。结论:ACS患者血清SAA、CRP、IL-6水平升高,提示与ACS的发生有关,是动脉粥样硬化斑块不稳定的标志,可以作为ACS的早期辅助诊断指标。
Objective: To observe the changes of serum inflammatory mediators C-reactive protein (CRP), amyloid A (SAA) and interleukin-6 (IL-6) levels and the relationship between inflammatory mediators in different types of patients with coronary heart disease To investigate the index of inflammation predicted by acute coronary syndrome (ACS). Methods: Serum levels of CRP, SAA and IL-6 in 32 patients with acute myocardial infarction, 30 patients with unstable angina pectoris, 20 patients with stable angina pectoris and 16 healthy controls were detected by enzyme - linked immunosorbent assay. The above indexes and differences Type Coronary heart disease, the relationship between ACS and non-ACS. Results: Serum levels of CRP, SAA and IL-6 in ACS patients were significantly higher than those in non-ACS patients (6.94 ± 4.56 vs 2.48 ± 2.32 mg / L, 217.23 ± 441.14 and 18.18 ± 28.05 mg / L, respectively) ; (4.37 ± 6.35): (1.31 ± 0.98) ng / L respectively (all P <0.01). There was a significant positive correlation between CRP, SAA and IL-6. The sensitivity of ACS was 73.8%, the specificity was 91.7% and the accuracy was 80.4% with the combination of cut off value of x- ± 2s of CRP, SAA and IL-6. Conclusions: Serum levels of SAA, CRP and IL-6 in patients with ACS are higher than those in patients with ACS, suggesting that ACS is associated with the occurrence of ACS. It is a marker of atherosclerotic plaque instability and can be used as an early auxiliary diagnostic indicator of ACS.