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目的探讨尿微量白蛋白排泄率(UAER)与超敏C-反应蛋白(hs-CRP)在不稳定型心绞痛诊断中的临床意义。方法将178例临床诊断为不稳定型心绞痛患者分为初发劳力型心绞痛组46例,恶化劳力型心绞痛组50例,自发型心绞痛组54例及梗死后心绞痛组28例;同期正常体检者40例作为对照组,分别应用免疫金标法测定尿微量白蛋白排泄率,免疫比浊法测定超敏C-反应蛋白水平,并进行比较。结果初发型心绞痛组和恶化型心绞痛组的UAER及hs-CRP均有很大程度的增高,二者显著高于对照组(P<0.01);梗死后心绞痛组UAER明显高于对照组(P<0.05),hs-CRP在正常范围;自发型心绞痛组两项测定指标均在正常范围。结论在心绞痛的早期应该注意监测UAER和hs-CRP的变化,以其尽早干预心绞痛的病程进展,对于恶化型劳力型心绞痛需在心肌酶谱和心电图等监测的同时结合UAER和hs-CRP的改变及时采取必要的治疗措施,以阻止或延缓心肌梗死的发生。
Objective To investigate the clinical significance of urinary albumin excretion rate (UAER) and high sensitivity C-reactive protein (hs-CRP) in the diagnosis of unstable angina pectoris. Methods A total of 178 patients with unstable angina pectoris were divided into primary angina pectoris group (n = 46), exacerbated angina pectoris group (n = 50), spontaneous angina pectoris group (n = 54) and infarct angina pectoris group Cases as a control group, respectively, the application of immunogold assay urinary albumin excretion rate, immunoturbidimetry determination of high-sensitivity C-reactive protein levels, and compared. Results UAER and hs-CRP in both primary angina group and advanced angina group were significantly higher than those in control group (P <0.01). UAER in patients with post-infarction angina group was significantly higher than that in control group (P < 0.05), hs-CRP in the normal range; spontaneous angina group two indicators were in the normal range. Conclusion In the early stage of angina pectoris, attention should be paid to monitor the changes of UAER and hs-CRP, as soon as possible to progress the course of angina pectoris. In the case of exacerbated exertion angina pectoris, changes of UAER and hs-CRP should be monitored in combination with monitoring of myocardial enzymes and electrocardiogram Timely take the necessary treatment to prevent or delay the occurrence of myocardial infarction.