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目的：探讨原发性高血压（essential hypertension, EH）患者向急性心肌梗死（acute myocardial infarction, AMI）转化时生物标志物[同型半胱氨酸（homocysteine, HCY），心肌肌钙蛋白I（cardiac troponin I, cTnI），C-反应蛋白（C-reactive protein, CRP），D-二聚体（D-dimer, D-D）]水平的临床价值。方法采用化学发光免疫分析和免疫比浊法分别测定276例EH患者（35例血压控制达标组，77例EHⅠ级组，86例EHⅡ级组和78例EHⅢ级组），51例AMI组和60名对照组血清生物标志物水平，并进行比较性研究。受试者工作特征曲线（receiver operating characteristic curve，ROC curve）评估EH向AMI转化时HCY、cTnI、CRP和D-D水平的临床价值。结果血清生物标志物水平随EH患者的严重程度而增加， EH患者生物标志物水平显著高于对照组。AMI患者生物标志物水平显著高于对照组（P均＜0.001）。ROC曲线评估EH向AMI转化时曲线下面积（area under curve, AUC）依次为HCY、cTnI、CRP和D-D，临界值分别为73.35μmoL/L、0.138 mg/L、16.38 mg/L和1.87 mg/L，敏感度、特异度、阳性预测值和阴性预测值亦依次为HCY、cTnI、CRP和D-D，均具有EH向AMI转化时的临床价值，以HCY和cTnI为最佳。结论血清HCY、cTnI、CRP和D-D水平随EH患者的严重程度而增高，并是EH向AMI转化时的有价值指标，以HCY和cTnI为最好。“,”Objective To explore the clinical value of serum biomarkers levels on essential hypertension (EH) found out AMI.MethodsThe serum HCY, cTnI, CRP and D-D levels were determined in 276 patients with EH(including 35 cases normal pressure EH, 77 cases stageⅠ EH, 86 cases stageⅡ EH and 78 cases stageⅢ EH), 51 cases AMI and 60 normal controls by CLIA and immunoturbidimetry and compared study was done. The ROC curve was plotted to analyze HCY, cTnI, CRP and D-D as a prognostic clinical value indicator of EH found out AMI.ResultsThe biomarkers levels increased in EH patients with EH severity and signiifcantly higher than those of control group, but the biomarkers were obviously higher in AMI patients than those of control group (P all<0.001). The ROC curve analysis showed that AUC for EH found out AMI were HCY, cTnI, CRP and D-D respectively; cut off values were 73.35μmoL/L, 0.138 mg/L, 16.38 mg/L and 1.87 mg/L respectively, the sensitivity, speciifcity, positive predictive value and negative predictive value were HCY, cTnI, CRP and D-D also. They had a clinical value of EH found out AMI, the best were HCY and cTnI.Conclusion The serum HCY, cTnI,CRP and D-D levels increased with EH severity and were valuable index of EH found out AMI, the best were HCY and cTnI.