在急性冠脉综合征测定肾上腺髓质素和超敏C反应蛋白的意义

摘要

Objective:To explore the clinical significance detecting adrenomedullin (ADM)and high sensitive C reac-tive protein (hsCRP)in patients with acute coronary syndrome (ACS).Methods:A total of 51 inpatients,which were eliminated for coronary heart disease (CHD)by coronary angiography (CAG),were enrolled as non CHD group,and 124 ACS patients diagnosed by CAG were regarded as ACS group.ADM and hsCRP concentrations were measured before and after CAG in non CHD group and before and after percutaneous coronary intervention (PCI) in ACS group,and they were compared between two groups.Results:Before CAG/PCI,compared with non CHD group,ADM [(28.7±1.6)pg/ml vs.(36.7±2.5)pg/ml]and hsCRP [(4.74±3.21)mg/L vs.(27.65±11.76) mg/L]levels significantly rose in ACS group,P<0.05 or <0.01.Compared with before PCI,there were signifi-cant increase in levels of ADM [(36.7±2.5)pg/ml vs.(47.1±5.3)pg/ml]and hsCRP [(27.65±11.76)mg/L vs.(39.53±4.83)mg/L]in ACS group after PCI,P<0.01 both,and significantly higher than those of non CHD group (P<0.05~<0.01).There were no significant difference in ADM and hsCRP levels in non CHD group be-tween before and after CAG (P>0.05 all).Conclusion:Detecting arenomedullin combined high sensitive C-reac-tive protein is gelpful to early diagnosis and evaluating lesion severity for acute coronary syndrome.%目的：探讨在急性冠脉综合征（ACS）患者测定肾上腺髓质素（ADM）和超敏 C-反应蛋白（hsCRP）的意义。方法：选择51例经冠脉造影排除冠心病的住院患者（非冠心病组）和124例经冠脉造影确诊为 ACS的患者（ACS组）。测定非冠心病组冠脉造影前后及 ACS组冠脉介入治疗前后 ADM和 hsCRP 的浓度，并进行统计学比较。结果：在造影/介入治疗前，与非冠心病组比较，ACS组 ADM [（28.7±1.6）pg/ml比（36.7±2.5）pg/ml]和 hsCRP [（4.74±3.21）mg/L比（27.65±11.76）mg/L]水平明显升高（P＜0.05或＜0.01）。与冠脉介入前比较，ACS组在冠脉介入后 ADM [（36.7±2.5）pg/ml比（47.1±5.3）pg/ml]和 hsCRP [（27.65±11.76）mg/L比（39.53±4.83）mg/L]水平显著上升（P均＜0.01），且显著高于非冠心病组（P＜0.05～＜0.01）。非冠心病组在冠脉造影前后 ADM和 hsCRP水平无统计学差异（P均＞0.05）。结论：测定肾上腺髓质素联合超敏 C-反应蛋白水平有助于急性冠脉综合征早期诊断及其病变严重程度判断。