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目的:探讨联合检测血清新蝶呤和C反应蛋白(C reactiveprotein,CRP)对急性心肌梗死患者预后的判断价值。方法:检测并比较102例急性心肌梗死(acutemyocardialinfarction,AMI)患者、106例不稳定型心绞痛(unstableangina,UA)患者、60名健康成人(对照组)的血清新蝶呤、CRP水平,记录AMI组住院及随访期间的心脏性猝死、再发性梗死、心绞痛等事件发生情况。结果:AMI组新蝶呤、CRP升高率及平均水平明显高于UA组及对照组(P<0.01或P<0.05)。AMI组入院时及3日后的血清新蝶呤、CRP水平相似,均明显高于2周后(均为P<0.01)。血清新蝶呤或CRP升高者,住院及随访期间心脏事件发生率显著高于新蝶呤或CRP不升高者(P<0.05)。血清新蝶呤或CRP对心脏事件的阳性预测值相似,但均明显低于两者联合检测时(P<0.01)。校正其他因素后,血清新蝶呤、CRP单项和两者均升高的AMI患者发生心脏事件的优势比(95%可信区间)分别为2.0(1.1～3.7)、0.4(0.1～7.7)、12.9(2.3～73.2)。结论:联合检测血清新蝶呤和CRP有助于对AMI患者预后的判断。
Objective: To explore the value of combined detection of serum neopterin and C reactive protein (C-reactive protein) in the prognosis of patients with acute myocardial infarction. Methods: The levels of serum neopterin and CRP in 102 patients with acute myocardial infarction (AMI), 106 patients with unstable angina (UA) and 60 healthy adults (control group) were detected and compared. The AMI group During hospitalization and follow-up of sudden cardiac death, recurrent infarction, angina and other events. Results: The levels of neopterin and CRP in AMI group were significantly higher than those in UA group and control group (P <0.01 or P <0.05). The levels of serum neopterin and CRP in AMI group were significantly higher than those at 2 weeks after admission (all P <0.01). Serum neopterin or elevated CRP, hospitalization and follow-up of cardiac events was significantly higher than neopterin or CRP did not rise (P lt; 0.05). Serum neopterin or CRP positive predictive value of cardiac events were similar, but were significantly lower than the two combined test (P <0.01). After adjusting for other factors, odds ratios (95% CI) were 2.0 (1.1-3.7) and 0.4 (0.1-7.7) for cardiac events in AMI patients with elevated serum neopterin, CRP, and both, 12.9 (2.3 ~ 73.2). Conclusions: Combined detection of serum neopterin and CRP may be helpful in judging the prognosis of patients with AMI.