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目的探讨C-反应蛋白(CRP)和肌钙蛋白Ⅰ(cTnI)联合检测在急性冠状动脉综合征(ACS)中的诊断价值。方法分别测定68例急性冠状动脉综合征患者(AMI组36例、UAP组32例)和33例稳定型心绞痛患者(SAP组)胸痛发作6h血清CRP浓度及cTnI含量,并与健康对照组比较。CRP采用免疫散射比浊法定量测定,cTnI采用单抗双夹心ELISA法定量检测。结果AMI组、UAP组、SAP组和健康对照组的CRP分别为(7.42±2.32)、(3.94±1.06)、(1.92±1.22)、(0.91±0.86)mg/L;cTnI分别为(21.76±5.88)、(2.80±0.41)、(0.10±0.04)、(0.09±0.02)μg/L。AMI组与其他组相比,CRP及cTnI均显著增高,差异有统计学意义(P<0.01),UAP组显著高于SAP组及健康对照组,差异有统计学意义(P<0.01),而SAP组与健康对照组相比差异无统计学意义(P>0.05)。结论炎症在ACS的发展过程中起重要作用。CRP可作为判断冠心病严重程度的有效指标之一,其升高与动脉粥样硬化斑块内炎症有关。联合检测CRP、cTnI对ACS的早期鉴别诊断及预后判断具有更高的临床应用价值。
Objective To investigate the diagnostic value of combined detection of C-reactive protein (CRP) and troponin I (cTnI) in acute coronary syndrome (ACS). Methods Serum levels of CRP and cTnI in 68 patients with acute coronary syndrome (36 in AMI group, 32 in UAP group) and 33 with stable angina pectoris (SAP group) were measured and compared with those in healthy controls. CRP was quantitatively determined by immune nephelometry and cTnI was quantified by double antibody sandwich ELISA. Results The CRP in AMI group, UAP group, SAP group and healthy control group were (7.42 ± 2.32), (3.94 ± 1.06), (1.92 ± 1.22) and (0.91 ± 0.86) mg / 5.88), (2.80 ± 0.41), (0.10 ± 0.04) and (0.09 ± 0.02) μg / L, respectively. The CRP and cTnI in AMI group were significantly higher than those in other groups (P <0.01), while those in UAP group were significantly higher than those in SAP group and healthy control group (P <0.01) There was no significant difference between SAP group and healthy control group (P> 0.05). Conclusion Inflammation plays an important role in the development of ACS. CRP can be used as one of the effective indicators to judge the severity of coronary heart disease, and its increase is related to inflammation in atherosclerotic plaque. Joint detection of CRP, cTnI of ACS early differential diagnosis and prognosis have a higher clinical value.