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目的探讨P-选择素、C-反应蛋白(CRP)和心肌肌钙蛋白I(cTnI)对急性冠状动脉综合征(ACS)患者短期预后评估的作用。方法分别测定70例ACS患者入院时外周血的P-选择素、CRP和cTnI水平。随诊1个月,终点为心脏事件。同时测定18例健康成人的P-选择素作对照。结果ACS组的P-选择素水平较对照组明显增高(P<0.01),在70例ACS患者中P-选择素升高27例,CPR升高23例,cTnI升高38例。随诊期共发生心脏事件14例,各因子增高组的心脏事件率均较正常组高(均为P<0.05)。其与ACS预后关系的相对危险度分别是5.74、6.83和3.94(均为P<0.05)。阳性预测值分别是37%、34%和28%。这三种因子的联合试验对心脏事件的阳性预测值是42.9%。结论P-选择素与ACS发生有关;P-选择素、CRP和cTnI分别与ACS短期预后有关,可作为危险分层的指标之一;联合检测意义更大。
Objective To investigate the effect of P-selectin, C-reactive protein (CRP) and cardiac troponin I (cTnI) on the assessment of short-term prognosis in patients with acute coronary syndrome (ACS). Methods Peripheral blood P-selectin, CRP and cTnI levels were measured in 70 patients with ACS. Followed up for 1 month, the end of cardiac events. P-selectin was also measured in 18 healthy adults as control. Results The P-selectin level in ACS group was significantly higher than that in control group (P <0.01). In 70 ACS patients, 27 cases were elevated in P-selectin, 23 cases were elevated in CPR and 38 cases were elevated in cTnI. During the follow-up period, 14 cases of cardiac events occurred, and the incidence of cardiac events was higher in each factor group than in the normal group (all P <0.05). The relative risk associated with the prognosis of ACS was 5.74, 6.83 and 3.94, respectively (all P <0.05). The positive predictive value was 37%, 34% and 28% respectively. The positive predictive value of the combined effect of these three factors on cardiac events was 42.9%. Conclusion P-selectin is related to the occurrence of ACS. P-selectin, CRP and cTnI are related to the short-term prognosis of ACS, respectively, which may serve as one of the indicators of risk stratification.