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目的 探讨C反应蛋白 (CRP)与冠状动脉病变稳定性和心脏事件之间的关系。方法 选择经冠状动脉造影证实的稳定性心绞痛 30例 ,不稳定心绞痛患者 4 5例 ,入院后即刻 ,6h ,2 4h ,4 8h和 7d检验CRP和肌钙蛋白T(cTnT) ,根据患者是否发生主要心脏不良事件进行分类研究。结果 CRP的水平与冠状动脉病变的严重程度之间没有相关性 ,不稳定心绞痛患者CRP的水平 (4 3± 0 4 )mg/L明显高于稳定性心绞痛患者 (2 2± 0 3)mg/L ,P <0 0 1。发生心脏不良事件的患者其CRP和cTnT水平在任何时点均高于未发生者 ,P <0 0 1。线形回归分析显示入院后 4 8h内的CRP ,cTnT水平对主要心脏不良事件有预测价值 ,P <0 0 1。结论 心绞痛患者C反应蛋白和冠状动脉病变严重程度之间无明显的相关关系 ,而与冠脉病变的稳定程度相关 ,CRP和cTnT联合检测可用于急性冠脉综合征的危险分层。
Objective To investigate the relationship between C-reactive protein (CRP) and the stability of coronary artery disease and cardiac events. Methods 30 cases of stable angina pectoris confirmed by coronary angiography, 45 cases of unstable angina pectoris were selected. CRP and troponin T (cTnT) were detected immediately, 6h, 24h, 48h and 7d after admission according to whether the patients Major adverse cardiac events were classified. Results The level of CRP was not correlated with the severity of coronary artery disease. The level of CRP in patients with unstable angina (43 ± 0 4) mg / L was significantly higher than that of patients with stable angina (22 ± 0 3) mg / L, P <0 0 1. CRP and cTnT levels in patients with adverse cardiac events were higher at any time point than those who did not (P <0.01). Linear regression analysis showed that the levels of CRP and cTnT within 48 h after admission were predictive of major adverse cardiac events (P <0.01). Conclusion There is no significant correlation between C-reactive protein and the severity of coronary artery disease in patients with angina pectoris, but correlated with the degree of coronary artery disease. The combination of CRP and cTnT can be used in risk stratification of acute coronary syndrome.