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急性冠状动脉综合征患者的降钙素原:与高敏C反应蛋白、冠心病预后及严重程度的相关性

Procalcitonin in patients with acute coronary syndrome: correlation with high-sensitive C-reactive protein, prognosis and severity of coronary artery disease.

作者信息

Sentürk Tunay, Cordan Jale, Baran Ibrahim, Ozdemir Bülent, Güllülü Sümeyye, Aydinlar Ali, Göral Güher

机构信息

Department of Cardiology, Uludag University School of Medicine Bursa, Turkey.

出版信息

Acta Cardiol. 2007 Apr;62(2):135-41. doi: 10.2143/AC.62.2.2020233.

DOI:10.2143/AC.62.2.2020233
PMID:17536601
Abstract

OBJECTIVES

The aim of this study is to determine the relation of high-sensitive serum C-reactive protein (hsCRP) and procalcitonin with presence and severity of coronary artery disease and early prognosis in patients with acute coronary syndrome (ACS).

METHODS AND RESULTS

Procalcitonin and hsCRP levels were measured at admission and after 48 hours in 50 patients (41 men, 9 women) with ACS. The patients were assigned to three groups according to their clinical diagnosis: unstable angina pectoris (UAP) (Braunwald III-B), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). Incidences of adverse cardiac events were recorded in a 3-month follow-up. Coronary angiography was performed to evaluate presence and severity of coronary artery disease. In the groups of STEMI, NSTEMI and UAP, procalcitonin (P = 0.01 3, P = 0.045 and P = 0.000 1, respectively) and hsCRP (P = 0.000 1, P = 0.01 and P = 0.00 1, respectively) levels were significantly increased. No significant correlation was found between these markers and the presence and severity of coronary artery disease. There was no correlation between procalcitonin and hsCRP levels at admission and after 48 hours and primary end points after 3 months except in the group of UAP with revascularization procedure. In the group of UAP, hsCRP levels at 48 hours were found higher in the patients with a revascularization procedure (P = 0.04).

CONCLUSIONS

In conclusion, levels of hsCRP and procalcitonin are increased in patients with ACS but failed to correlate with severity of coronary disease and early prognosis.

摘要

目的

本研究旨在确定高敏血清C反应蛋白(hsCRP)和降钙素原与急性冠状动脉综合征(ACS)患者冠状动脉疾病的存在、严重程度及早期预后之间的关系。

方法与结果

对50例(41例男性,9例女性)ACS患者入院时及48小时后测定降钙素原和hsCRP水平。根据临床诊断将患者分为三组:不稳定型心绞痛(UAP)(Braunwald III - B型)、非ST段抬高型心肌梗死(NSTEMI)和ST段抬高型心肌梗死(STEMI)。在3个月的随访中记录不良心脏事件的发生率。进行冠状动脉造影以评估冠状动脉疾病的存在和严重程度。在STEMI、NSTEMI和UAP组中,降钙素原(分别为P = 0.013、P = 0.045和P = 0.0001)和hsCRP(分别为P = 0.0001、P = 0.01和P = 0.001)水平显著升高。未发现这些标志物与冠状动脉疾病的存在和严重程度之间存在显著相关性。入院时及48小时后的降钙素原和hsCRP水平与3个月后的主要终点之间无相关性,但接受血运重建术的UAP组除外。在UAP组中,接受血运重建术的患者48小时时的hsCRP水平较高(P = 0.04)。

结论

总之,ACS患者的hsCRP和降钙素原水平升高,但与冠状动脉疾病的严重程度和早期预后无关。

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