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目的探讨高敏 C 反应蛋白(hs-CRP)和心型脂肪酸结合蛋白(heart fatty acid bindingprotein,h-FABP)对不稳定性心绞痛(UAP)患者心脏意外事件的影响。方法将住院的心绞痛患者分成稳定性和不稳定性两组。其中,稳定性心绞痛(SAP)患者74例,男45例,女29例;UAP 患者56例,男29例,女27例。分别检测其血清 hs-CRP、h-FABP、心肌肌钙蛋白Ⅰ(cTn-I)和肌酸激酶-MB(CK-MB)的含量,并于2周内观察各组发生心脏意外事件的情况。并抽取同期门诊健康体检者50例作为对照组。结果 UAP 组的心脏意外事件发生率为26.8%,高于 SAP 组的10.53%(P<0.05);对照组无心脏意外事件发生。SAP 和 UAP 组患者血清 hs-CRP 的含量分别为(1.78±0.62)mg/L 和(7.64±2.18)mg/L,高于对照组的(0.59±0.27)mg/L(P<0.05,P<0.01);SAP 和 UAP 组血清h-FABP 的含量分别为(3.15±2.61)μg/L 和(16.46±5.28)μg/L,高于对照组的(1.83±0.75)μg/L(P<0.05,P<0.01);SAP 患者血清 cTn-I 的含量为(0.67±0.09)μg/L,与对照组(0.47±0.12)μg/L比较,差异无统计学意义(P>0.05)。UAP 组和 UAP 组中的Ⅲ级患者的血清 cTn-I 含量分别为(1.28±0.43)μg/L 和(2.14±1.49)μg/L,高于对照组的(0.47±0.12)μg/L(P<0.01)。而 UAP 组Ⅰ级和Ⅱ级患者其 cTn-1的含量为(0.53±0.13)μg/L 和(0.74±0.37)μg/L,与对照组比较差异无统计学意义;CK-MB 值各组间差异均无统计学意义。SAP 组中,发生心脏意外事件的患者其血清 hs-CRP 和 h-FABP 的含量分别为(6.32±2.06)μg/L 和(8.76±3.83)μg/L,高于对照组(P<0.01);UAP组中,发生心脏意外事件的患者其血清 hs-CRP、h-FABP 和 cTn-Ⅰ的含量分别为(9.82±3.15)μg/L、(22.21±8.87)μg/L和(2.68±0.48)μg/L,高于对照组(P<0.叭);另外,各组发生与未发生心脏意外事件的 CK-MB 值差异均无统计学意义。结论 hs-CRP、h-FABP 的联合检测较传统的心肌损伤检测指标 cTn-I 和 CK-MB 对 UAP 患者近期发生心脏意外事件的可能性具有更高的预测价值。
Objective To investigate the effects of hs-CRP and h-FABP on cardiac events in patients with unstable angina (UAP). Methods The hospitalized patients with angina were divided into two groups: stability and instability. Among them, 74 patients with stable angina pectoris (SAP), 45 males and 29 females; 56 patients with UAP, 29 males and 27 females. The levels of hs-CRP, h-FABP, cTn-I and CK-MB in serum were detected and the cardiac events in each group were observed within two weeks . And take out the same period outpatient health examination of 50 cases as a control group. Results The incidence of cardiac accident in UAP group was 26.8%, higher than that in SAP group (10.53%, P <0.05). No cardiac accident occurred in control group. The levels of hs-CRP in patients with SAP and UAP were (1.78 ± 0.62) mg / L and (7.64 ± 2.18) mg / L, respectively, higher than that of the control group (0.59 ± 0.27) mg / L <0.01). The levels of serum h-FABP in SAP and UAP groups were (3.15 ± 2.61) μg / L and (16.46 ± 5.28) μg / L, respectively, higher than that of the control group (1.83 ± 0.75 μg / L, P < 0.05, P <0.01). The level of serum cTn-I in patients with SAP was (0.67 ± 0.09) μg / L, which was not significantly different from that in the control group (0.47 ± 0.12) μg / L. Serum levels of cTn-I in patients with UAP and UAP were (1.28 ± 0.43) μg / L and (2.14 ± 1.49) μg / L, respectively, higher than that of the control group (0.47 ± 0.12) μg / L P <0.01). The levels of cTn-1 in patients with grade I and II of UAP group were (0.53 +/- 0.13) microg / L and (0.74 +/- 0.37) microg / L, respectively, and there was no significant difference compared with the control group There was no significant difference between the two groups. In the SAP group, the levels of serum hs-CRP and h-FABP in patients with cardiac events were (6.32 ± 2.06) μg / L and (8.76 ± 3.83) μg / L, respectively, higher than those in the control group (P <0.01) (9.82 ± 3.15) μg / L, (22.21 ± 8.87) μg / L and (2.68 ± 0.48), respectively, in UAP patients with cardiac accidental events ) μg / L, higher than the control group (P0.01). In addition, there was no significant difference in CK-MB between the groups with and without cardiac accident. Conclusions The combined detection of hs-CRP and h-FABP is more predictive of the recent cardiac accident probability in patients with UAP than the detection of cTn-I and CK-MB.