hs-CRP、BNP及D-二聚体与ACS近期不良心血管事件的关系

梁少兰; 靳文; 杜作义; 李自成

doi:10.13201/j.issn.1001-1439.2014.07.008

hs-CRP、BNP及D-二聚体与ACS近期不良心血管事件的关系

- 1 广东省第二人民医院心血管内二科(广州, 510317);
- 2 广州暨南大学附属第一医院心内科(广州, 510630)

详细信息

通讯作者: 李自成,E-mail:zichengli@163.net

中图分类号: R541.4

收稿日期: 2013-10-21

Relationship between hs-CRP,BNP,D-dimer and recent adverse cardiovascular events in patients with acute coronary syndrome

- 1 Department of Cardiology, the Second People's Hospital in Guangdong Province, Guangzhou, 510317, China;
- 2 Department of Cardiology, the First Affiliated Hospital of Jinan University, Guangzhou, 510630, China

More Information

Corresponding author: LI Zicheng, E-mail: zichengli@163.net

Received Date: 21 October 2013

摘要

摘要: 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。
- 急性冠状动脉综合征 /
- 高敏C反应蛋白 /
- 脑钠肽 /
- D-二聚体
Abstract: Objective: To explore the relationship between hs-CRP, BNP, d-dimer and recent adverse cardiovascular events in the patients with acute coronary syndromes (ACS).Method: 376 cases were chosed and performed coronary arteriography examination, including 120 cases with stable angina pectoris (SAP), 152 cases with unstable angina pectoris (UAP), 30 cases NSTEMI, 74 cases STEMI.We used immune fluorescence to detect BNP concentration.Immune turbidimetric method was used to determine the levels of hs-CRP and D-dimmer.Patients were followed up by telephone at 90 days after discharge, and recorded adverse cardiac events.Result: The incidence of adverse events in UAP group, NSTEMI group and STEMI group were 4.61%, 16.67% and 24.32% (P＜0.05) respectively.The levels of hs-CRP, BNP, D-dimer in STEMI group were higher than those in UAP and NSTEMI groups.Hypertension, hs-CRP, BNP, D-dimer, LDL were the high risk factors of the recent cardiac events in patients with ACS.Conclusion: hs-CRP, BNP, D-dimer are effective indicators of the recent cardiac events in patients with ACS.
- acute coronary syndrome /
- high sensitive C-reativeprotein /
- brain natriuretic peptide /
- d-dimer

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参考文献(9)

[1]	SANCHEZ P L, MORINIGO J L, PAHON P, et al.Prognostic relations between inflammatory markers and mortality in diabetic patients with non-ST elevation acute coronary syndrome[J].Heart, 2004, 90:264-267.
[2]	ARROYO-ESPLIGUE M, AVANZAS E, COSINSALES J, et al.C-reactive protein elevation and disease activity in patients with coronary artery disease[J].Eur Heart J, 2004, 25:401-408.
[3]	MAGGA J, PUHAKKA M, HIETAKORPI S, et al.Atria natriuretic peptide, 82type nalrimefic peptede and serum collagen markers after acute myocardial infarcion[J].Appl Phsiol, 2004, 96:1306-1311.
[4]	STEIN B C, LEVIN R L.Natrinrefic peptides:physiology, therapeutic potential, and risk stratification in ischemic heart disease[J].Am Heart J, 1998, 135:914-923.
[5]	陈容升, 张杰忠, 郑伟明, 等.冠心病患者D-二聚体及C反应蛋白的临床观察[J].国际医药卫生导报, 2007, 13 (23):17-19.
[6]	成忠, 吴婕, 王岚.快速D-二聚体检测对急性冠脉综合征的早期诊断价值[J].临床心血管病杂志, 2011, 27 (6):437-438.
[7]	刘金贵.高敏C-反应蛋白、同型半胱氨酸、D-二聚体在冠心病病情严重程度评估中的应用[J].医学检验与临床, 2011, 22 (5):51-53.
[8]	钟海英, 周贞学.检测血浆D-二聚体、FDP、TNT对心肌梗死病人的临床意义[J].中国实验诊断学, 2010, 14 (4):577-579.
[9]	王金行, 刘柏新, 周立平, 等.D-二聚体及肌钙蛋白T和心肌酶谱检测对诊断急性心肌梗死的意义[J].广东医学, 2012, 33 (4):522-523.