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目的动态研究急性冠状动脉综合征(ACS)患者住院期间静脉血中性粒细胞髓过氧化物酶(MPO)浓度改变及其临床意义。方法49例冠心病患者经临床和造影证实其中有急性心肌梗死(AMI)14例、不稳定型心绞痛(UAP)19例、稳定型心绞痛(SAP)16例,在急性发作期的1、2、3、7、10天5个时间点抽取静脉血测定中性粒细胞MPO水平,选取无心绞痛发作史的健康体检老年人16人为对照组。结果ACS(包括AMI和UAP)发作的10d内,其MPO水平始终明显高于SAP患者和对照组,差异均有统计学意义(均P<0.05);第1~3天,AMI组MPO水平均高于UAP组,差异均有统计学意义(均P<0.05),第7~10天,UAP患者的MPO水平已接近AMI组,差异无统计学意义(P>0.05);SAP患者入院第1天的MPO值明显高于对照组,差异有统计学意义(P<0.05),但随即恢复正常。结论动态观察MPO值的变化可预测冠心病患者冠状动脉中斑块的稳定情况,从而预测ACS事件的发生及预后。
Objective To dynamically study the changes of venous blood neutrophil myeloperoxidase (MPO) concentration in patients with acute coronary syndrome (ACS) during hospitalization and its clinical significance. Methods A total of 49 patients with coronary heart disease (CHD) were confirmed by clinical and angiography. Among them, 14 cases were acute myocardial infarction (AMI), 19 cases were unstable angina pectoris (UAP) and 16 cases were stable angina pectoris (SAP) Venous blood samples were collected at 5, 7, 10 days for determination of neutrophil MPO levels, and 16 healthy controls were selected as the control group. Results The levels of MPO in ACS group (all AMI group and UAP group) were significantly higher than those in SAP group and control group (all P <0.05) (All P <0.05). From the 7th to the 10th day, the MPO level in UAP patients was close to that of AMI patients (P> 0.05) Day MPO value was significantly higher than the control group, the difference was statistically significant (P <0.05), but then returned to normal. Conclusions The dynamic observation of the changes of MPO value can predict the stability of plaque in the coronary artery of patients with coronary heart disease so as to predict the occurrence and prognosis of ACS.