联合监测白细胞与C反应蛋白对急性冠状动脉综合征预后判断的意义

摘要

目的 探讨联合检测白细胞和C反应蛋白对急性冠状动脉综合征(ACS)预后的判断价值.方法 检测并比较152例急性冠状动脉综合征患者(ACS组)与120名健康成人(健康对照组)的白细胞计数、中性粒细胞/淋巴细胞比率和C反应蛋白水平,并随访记录所有急性冠状动脉综合征患者6个月内再次有心脏性猝死、再发性梗死、梗死后或新发生心绞痛等心血管事件发生情况,分别以白细胞计数、中性粒细胞/淋巴细胞比率和C反应蛋白水平分组,比较各组急性冠状动脉患者心血管事件再次发生率的差异.结果 ACS组患者白细胞计数、中性粒细胞/淋巴细胞比率和C反应蛋白水平显著高于健康对照组(P＜0.05).随访结果表明C反应蛋白、白细胞计数及中性粒细胞/淋巴细胞比率升高组的ACS患者心血管事件再发生率分别为47%、54%和49%,显著高于C反应蛋白、白细胞计数及中性粒细胞/淋巴细胞比率正常的各组ACS患者(16%、8%和15%)(P＜0.05).C反应蛋白和白细胞计数或与中性粒细胞/淋巴细胞比率两者均升高的ACS患者再次发生心血管事件阳性预测值(69%)或三者均升高的阳性预测值(76%)明显高于各项仅单项升高者(P＜0.01).结论 联合检测白细胞和C反应蛋白有助于ACS患者预后的判断.%Objective To evaluate the prognostic significance of combined detection ofleukocytes and C-reactive protein for acute coronary syndrome. Methods Determined and compared white blood cell count, neutrophil/ lymphocyte ratio and C-reactive protein levels of the 152 patients with acute coronary syndrome patients and 120 healthy adults and follow-up recorded the recurrence rates of cardiovascular events of the all acute coronary syndrome patients within six months. Results The white blood cell count, neutrophil / lymphocyte ratio and C-reactive protein level in patients with acute coronary syndrome were significantly higher than those in the control group, the difference was statistically significant (P＜0.05). C-reactive protein, white blood cell count and neutrophil/lymphocyte ratio increased group of cardiovascular events in patients with acute coronary syndrome recurrence rates were 47％, 54％ and 49％, significantly higher than the C reaction protein, white blood cell count and neutrophil/lymphoeyre ratio of the normal ACS patients in each group (16％, 8％ and 15％), the differences between the two groups was statistically significant (P＜0.05). C-reactive protein and white blood cell count or neutrophil / lymphocyte ratio increased both in patients with acute coronary syndrome recurrence of cardiovascular events in a positive predictive value (69％), and all of those increased positive predictive value (76％) were higher than the only individual elevated (P＜ 0.01). Conclusion The detection of leukocytes and C-reactive protein in patients with acute coronary syndromes contributes to prognosis.