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目的：探讨联合检测血清单核细胞趋化蛋白-1（MCP-1）、活化T 细胞趋化因子（RANTES）及半胱氨酸蛋白酶抑制剂C(Cys C)对急性冠状动脉综合征（ACS）患者的早期诊断和预后评估价值。方法：选择200 例于2012 年10 月到2013 年10 月在本院就诊的冠心病患者200 例，其中ACS患者120 例（为ACS 组），另稳定型心绞痛（SAP）患者80 例（SAP 组），另选择同期40 例健康人为对照组。115例患者有冠状动脉粥样硬化，其中40 例钙化斑块组、42 例纤维斑块组及33 例软斑块组，进行CT 检查；用双抗体夹心酶联免疫（ELISA）法检测患者血清MCP-1、RANTES、Cys C及高敏C反应蛋白(Hs-CRP)水平，并用logistic 回归方程评价联合检测MCP-1、RANTES 及Cys C预测ACS 的效果。结果：与SAP 组、对照组相比，ACS 组患者MCP-1、RANTES、Cys-C、 Hs-CRP、LDL-C 及空腹血糖(FBG)浓度均明显升高（P<0.05）；HDL-C浓度明显降低（P<0.05）；与纤维斑块组、钙化斑块组相比，软斑块组MCP-1、RANTES 及Cys-C 浓度均明显升高（P<0.05）；与钙化斑块组相比，纤维斑块组MCP-1、RANTES 及Cys-C 浓度均明显升高（P<0.05）；联合检测血清MCP-1、RANTES、Cys-C 预测ACS 患者，阳性准确率为89.2%，阴性准确率为92.5%，综合准确率为90.8%，明显高于单纯Hs-CRP的检测方法（P<0.05）。结论：血清MCP-1、RANTES及Cys C联合检测对急性冠状动脉综合征的诊断效果优于单纯检测Hs-CRP。该联合检测方法具有一定的临床应用价值。

英文摘要:

Objective:To investigate the role of combination detection of MCP-1, RANTES and Cys C in identification and prognosis of acute coronary syndrome (ACS).Methods:200 coronary heart disease patients who treated in our hospital from October 2012 to October 2014 were selected, 120 cases of ACS were allocated to ACS group and the other 80 patients with stable angina pectoris were SAP group. Another 40 healthy persons were chosen as control group.115 patients with coronary heart disease accompanied by atherosclerosis and were divided into calcified plaque group with 40 cases, fibrous plaque group with 42 cases and soft plaque group with 33 cases, and allcases were performed CT examination. MCP-1, RANTES, Cys C and high sensitive C were determined by enzyme linked immunosorbent assay. The effect of combined detection of MCP-1, RANTES, and Cys C was evaluated with Logistic regression equation.Results:Compared with the control group and the SAP group, MCP-1, RANTES, Cys-C, Hs-CRPLDL-C and FBG concentrations of the ACS group were significantly increased (P<0.05), and HDL-C concentration decreased significantly (P<0.05). Compared with fibrous plaque group and calcified plaque group of coronary heart disease in patients, MCP-1, RANTES or Cys-C concentrations of soft plaque group were significantly increased (P <0.05). Compared with calcified plaque group of coronary heart disease in patients, MCP-1, RANTES or Cys-C concentrations of fibrous plaque group were significantly increased (P <0.05).Combined detection of serum MCP-1, RANTES, Cys-C for predicting ACS patients, the positive accuracy rate was 89.2%, negative accuracy was 92.5%, overall accuracy was 90.8%, significantly higher than the detection methods alone with Hs-CRP(P <0.05).Conclusion:Compared with the detection of hs-CRP, the combined detection of MCP-1, RANTES and Cys C has obvious advantages, especially in the early recognition of ACS. This detection method has great clinical value for clinical promotion.

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