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1、2内蒙古医科大学硕士研究生学位论文（2015）hs-CRP单项阳性检出率77.78%，D-D单项阳性检出率75.56%,联合检测的阳性率高于单项检测。结论：理论意义hs-CRP和D-D两项指标的高水平表达，与ACS的斑块内局部炎症反应、斑块破裂、血栓形成、纤溶亢进，密切相关。现实意义(1)hs-CRP对ACS的早期诊断、病情评估具有重要的临床意义。(2)D-D对ACS的早期诊断、有较高临床意义，对病情评估、有很大的参考价值。(3)hs-CRP和D-D联合检测对ACS的早期诊断、病情评估临床意义更大,尤其对AMI而言。本文AMI组联合检测的阳性率明显高于单项检测，表明hs-CRP和D-D联合
2、检测，使ACS高危患者诊断的敏感性及特异性明显增高，能更为客观、准确地评估病情，降低漏诊及误诊率，从而及早有效地指导临床治疗；这是我们本项研究的创新点和独到之处。关键词超敏C反应蛋白D-二聚体联合检测急性冠脉综合征临床意义万方数据内蒙古医科大学硕士研究生学位论文（2015）3ABSTRACTAcutecoronarysyndrome(ACS)isakindofclinicalsyndrome,causedbymyocardialischemia.Itcanbepartedintotwotypes:acutemyocardialinfarction(AMI),whichisdividedin
3、toSTsegmentelevationmyocardialinfarction(STEMI)andnon-STEMI(NSTEMI)further,andunstableanginapectoris(UAP).ACSisemergencyandcriticalincardiovascularsystem.Aspathologicalandphysiologicalbasis,endangiuminjury,plaquerupture,thrombusformationallcancontributetoseverearterystenosis,severearterialocclusio
4、nandcardiacmusclecellischemiaandhypoxia.Atherosclerosisbelongstotheinflammatoryresponse,andCRPisthemarker,whichgets,althoughlowspecificity,relativelyhighsensitivity,especiallyinACS.Theinflammatoryresponseisanimportantreasonforplaquerupture.CRPisakeyriskfactorincardiovasculardisease.D-Dimer(D-D)isa
5、molecularmarkerofhyperfibrinolysisandoneofpredictivefactorforthrombus.TheincreaseofD-DcanreflectthatatheroscleroticplaqueofACSisinanactivestageandactivatedthrombushasformed.D-DplaysavaluableroleindiagnosisofACStype,dangerouslevelandtreatment.ThisstudyfocusesonmeasuringCRPandD-DlevelofACSpatientsin
6、ordertomakeanearlydiagnosis,correctassessmentofdiseasestageandprognosis,andeffectiveguidancetowardsclinicaltreatmentofACS,whichcouldprovideexperimentalandtheoreticalbasisfurther.PurposeInordertoensurevalueofhs-CRPandD-DdetectionforearlydiagnosisandclinicalguidanceinACSpatients.Method(1)FromNovembe
7、r2013toNovember2014,90ACScaseshadbeenenrolledaccordingtoWHOdiagnosisstandard;inaddition,30cases,whowasingoodhealthaccordingtophysicalexaminationandwithoutcardiovasculardisease,hadbeenenrolledascontrolgroupduringt
