目的：研究血清胱抑素C （ Cys C ）和高敏C反应蛋白（ hsCRP ）水平与老年急性冠脉综合征（ ACS）的关系及其临床意义。方法选择住院经冠状动脉造影检查的老年患者共172例，并结合临床表现、心电图、心肌酶学等检查结果分为急性心肌梗死组（ AMI，46例）、不稳定型心绞痛组（ UAP，44例）、稳定型心绞痛组（ SAP，42例）和健康对照组（40例）四组。检测各组血清Cys C、hsCRP水平，并收集研究对象一般资料及生化检查结果。结果（1）ACS各组与SAP组和对照组患者的年龄、性别、吸烟史、高血压史、糖尿病史、高血脂史等比较差异无统计学意义（P＞0．05）；（2）ACS各组血清Cys C水平与SAP组和对照组比较，差异有统计学意义（P＜0．05），其中UAP组显著高于SAP组和对照组，AMI 组低于SAP组和对照组；（3）ACS各组血清hsCRP水平显著高于SAP组和对照组，同时ACS中 AMI组血清hsCRP水平明显高于UAP组，差异有统计学意义（ P＜0．05）。结论血清Cys C和hsCRP水平与老年ACS 有着一定的关系，可能是老年ACS的危险因素。临床上联合检测血清Cys C和hsCRP水平对老年ACS的诊断和病情预测有一定价值。%Objective To investigate the clinical significance and association between serum Cys C ,hsCRP and acute coronary syndrome ( ACS) in elderly patients .Methods A total of 172 elderly patients were selected by coronary angiography, including 46 patients with acute myocardial infarction (AMI),44 patients with unstable angina pectoris(UAP),42 patients with stable angina pectoris(SAP)and 40 healthy cases as controls.Levels of Cys C and hsCRP in serum were measured by immunoturbidimetry ( ITM) in all cases.The general information and serum bio-chemical indexes of all the objects were also collected .Results (1) There were no statistical differences in age ,sex, smoking,hypertension,diabetes and hyperlipidemia among all groups (P>0.05).(2)Cys C levels were significantly higher in UAP patients than those in SAP patients and controls ,while serum Cys C in AMI patients were much lower than those in SAP patients and controls (P<0.05).(3)Serum hsCRP concentrations in ACS groups were significantly higher than those in SAP group and control group ,while hsCRP levels in ACS ,AMI group were much higher than UAP group and the difference was statistically significant (P<0.05).Conclusion Levels of Cys C and hsCRP in serum are closely related to ACS in elderly patients ,which possibly may be risk factors for elderly ACS .Thus,combined measurement of serum Cys C and hsCRP levels may be valuable for the diagnosis and prognosis of elderly ACS .
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