急性冠脉综合征患者血清炎性指标及肌钙蛋白I的临床研究

急性冠脉综合征患者血清炎性指标及肌

钙蛋白I的临床研究

（作者:___________单位: ___________邮编: ___________）

【摘要】目的研究急性冠脉综合征患者（ACS）血清炎性指标的水平与肌钙蛋白I的关系及临床意义。方法测定冠脉造影阳性的ACS患者74例、稳定型心绞痛（SAP）患者58例和造影阴性的冠心病患者46例（对照组）血清超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、可溶性P-选择素(sP-sel)和肌钙蛋白I(cTnI)的水平，并采集相应的各项临床资料。结果ACS组患者血清各项炎性指标分别为hs-CRP(7.40±2.90)mg/L、IL-6(235.62±87.03) ng/L、sP-sel（87.82±36.02）mg/L、cTnI(4.38±3.85)mg/L, 高于SAP组患者和对照组，差异均有统计学意义（t分别=6.52、4.94、2.97、7.23、8.96、5.63、3.32、8.67，P均＜0.05）；cTnI增高患者各血清炎性指标分别为hs-CRP(8.74±1.61)mg/L、IL-6(265.33±66.62) ng/L、sP-sel（99.43±25.42）mg/L, 明显高于cTnI正常者，差异均有统计学意义(t分别=4.59、3.92、3.65,P均＜0.05)。结论血清炎性指标在ACS患者中均表现为增高。cTnI与血清各项炎性指

标具有相关性。cTnI及血清各项炎性指标与冠脉内斑块的不稳定状态具有相关性。

【关键词】急性冠脉综合征炎性指标肌钙蛋白I

Clinical research on serum levels of inflammatory indicators and cardial troponin I in patients with acute coronary syndrome LIN Jianping, WU Guohua.Center of Clinical Laboratory，Wuyi First People’s Hospital, Wuyi 321200, Ｃｈｉｎａ

ＡｂｓｔｒａｃｔＯｂｊｅｃｔｉｖｅTo explore relationship and clinical significance of serum levels of inflammatory indicators and cardial troponin I in patients with acute coronary syndrome(ACS). Methods Serum levels of high sensitivity C reactive protein(hs-CRP), interleukin-6 (IL-6), solubility P-selectin(sP-sel), cardial troponin I(cTnI) in 74 cases of positive coronary visualization patients with ACS,58 cases of patients with stable angina pectoris (SAP) and 46 cases of negative coronary visualization patients with coronary heart disease(CHD)（control group）were determined. Related clinical data of these patients were analyzed. Results The serum levels of inflammatory indicators of positive cTnI patients were hs-CRP(8.74±1.61) mg/L；IL-6(265.33±66.62) ng/L；sP-sel（99.43±25.42）mg/L. And those of ACS group were hs-CRP （7.40±2.90 ）mg/L；IL-6(235.62±87.03) ng/L；sP-sel（87.82±36.02）mg/L; cTnI(4.38±3.85)mg/L. The serum

levels of each inflammatory indicators of patients in ACS group were significantly higher than that of patients in SAP group and control group (t=6.52, 4.94, 2.97, 7.23，8.96, 5.63, 3.32, 8.67, P0.05).The serum levels of each of inflammatory indicators of positive cTnI patients was significantly higher than that of negative cTnI patients (t=4.59,3.92,3.65,P0.05). Conclusions The serum levels of each of inflammatory indicators of patients with ACS are increasing，and cTnI is associated with serum inflammatory indicators. cTnI and inflammatory indicators are associated with instability of coronary plaque.

Ｋｅｙｗｏｒｄｓacute coronary syndrome; inflammatory indicators; cardial troponin I

冠脉粥样斑块不稳定是急性冠脉综合症（acute coronary syndrome，ACS）发生的基本病理因素。动脉管壁内炎症在不稳定斑块的发生、演变及破裂过程中起着至关重要的作用[1]。斑块内的炎性细胞及其炎性产物的近期反应活跃，可能是斑块不稳定、斑块破裂的促发因素。近些年来，血清低水平肌钙蛋白I（cardial troponin I ，cTnI）的测定在临床上开始应用，在诊断和预测ACS发生的可能性方面有重要的临床意义[2]。本次研究主要对冠心病患者血清炎性指标和cTnI进行了测定，以探讨这些指标在ACS发生的可能机制和相关性。现报道如下。

1 资料与方法