目的：探讨联合检测超敏C反应蛋白（ hs-CRP）、肌钙蛋白I（ cTnI）及和肽素（ copeptin）对早期不稳定型心绞痛（ UAP）的临床意义。方法选取2012年5月—2014年3月广东医学院附属三水医院确诊的89例UAP患者作为UAP组，从胸痛发作到入院时间≤4 h，根据冠状动脉不同病变分为左主干病变（ LMCA）组26例、单支病变（ XV）组25例、双支病变（ DV）组22例和三支病变（ TV）组16例；另选取同期89例健康志愿者作为对照组。比较两组受检者及冠状动脉不同病变组患者血清hs-CRP、cTnI及copeptin水平。结果 UAP组hs-CRP、cTnI及copeptin分别为（7.76±3.93）mg/L、（19.54±3.65）μg/L、（25.78±6.21）pmol/L，分别高于对照组的（1.25±0.36）mg/L、（1.44±0.68）μg/L、（5.44±3.89）pmol/L（P﹤0.05）。LMCA组和TV组患者血清hs-CRP水平高于XV组（P﹤0.05）；LMCA组和TV组患者血清cTnI和copeptin水平高于XV组、DV组（P﹤0.05）。结论 UAP患者血清cTnI、hs-CRP及copeptin水平明显升高，联合检测三者能提高早期UAP诊断准确性且能更好地判断冠状动脉病变严重程度。%Objective To investigate the clinical significance of combined detection of hs-CRP,cTnI and copeptin on early unstable angina. Methods A total of 89 early unstable angina patients were selected as UAP group in Xanshui Hospital Affiliated to Guangdong Medical College from May 2012 to March 2014,all of them admitted to hospital within 4 hours after onset of chest pain;a total of 89 healthy cases were selected as control group at the same time. Patients of UAP group was divided into 4 subgroups according to coronary artery lesions,including left main coronary artery lesions(A group,n=26),single vessel lesions(B group,n=25),double vessel lesions(C group,n=22),three vessel lesions(D group,n=16). Xerum levels of hs-CRP,cTnI and copeptin were detected and compared. Results Xerum hs -CRP,cTnI and copeptin levels of UAP group was(7.76 ±3.93)mg/L,(19.54 ±3.65)μg/L,(25.78 ±6.21)pmol/L,respectively,was higher than(1.25 ±0. 36)mg/L,(1. 44 ±0. 68)μg/L,(5. 44 ±3. 89)pmol/L of control group,respectively(P﹤0. 05). Xerum hs-CRP level of A group and D group was higher than that of B group,respectively(P ﹤0. 05);serum cTnI and copeptin levels of groups A and D were higher than that of groups B and C,respectively(P﹤0. 05). Conclusion Xerum cTnI,hs-CRP and copeptin levels of early unstable angina patients are higher, combined detection of them can exactly diagnose early unstable angina,preferably judge the severity of coronary artery lesions.
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