急性冠脉综合征相关血清学标志物研究进展

Advances in Serological Markers Associated with Acute Coronary Syndrome

摘要: 急性冠脉综合征(ACS)是由急性心肌缺血引起的一组临床综合征，具有起病急、病情变化快、病死率高等特点，主要包括ST段抬高型心肌梗死(STEMI)、非ST段抬高型心肌梗死(NSTEMI)和不稳定性心绞痛(UA)。临床表现为胸骨后闷痛、恶心、呼吸困难、窒息感等，严重者甚至会晕厥，严重影响患者的生活质量。急性冠脉综合征的血清标志物主要有肌钙蛋白、超敏C反应蛋白、高迁移率族蛋白B1、脑钠肽。心肌肌钙蛋白水平与急性心肌梗死的发病有显著的相关性，能敏感地反应心肌损伤，是诊断心肌缺血的首选标志物。超敏C反应蛋白是由肝脏合成的一种全身性炎症反应急性期的非特异性标志物，与心血管疾病的发生有着密切的关系。高迁移率族蛋白B1是近几年发现的一种致炎细胞因子，参与了诸多炎症免疫应答。脑钠肽是是反应心功能的可靠指标，是急性冠脉综合征患者死亡最强大的预测物。

Abstract: Acute Coronary Syndromes (ACS), a group of clinical syndromes caused by acute myocardial ische-mia, are characterized by rapid onset, rapid disease change and high mortality, mainly including ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarc-tion (NSTEMI) and unstable angina pectoris (UA). Clinical manifestations include poststernal pain, nausea, dyspnea, asphyxia, etc., and even syncope in severe cases, which seriously affects patients’ quality of life. The main serum markers of acute coronary syndrome were troponin, hypersensitive C-reactive protein, high mobility group protein B1 and brain natriuretic peptide. Myocardial tro-ponin level has a significant correlation with the incidence of acute myocardial infarction, can sensi-tively reflect myocardial injury, and is the preferred marker for the diagnosis of myocardial ische-mia. Hypersensitive C-reactive protein is a nonspecific marker of the acute phase of systemic in-flammatory response synthesized by the liver, which is closely related to the occurrence of cardio-vascular diseases. High mobility group protein B1 is a kind of inflammatory cytokine discovered in recent years, which is involved in many inflammatory immune responses. Brain natriuretic peptide is a reliable indicator of cardiac function and the strongest predictor of death in patients with acute coronary syndrome.