血清Cys-C、Lp(a)、BNP、hs-CRP与冠脉综合征急性期的相关性研究
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摘要
目的:研究血清胱抑素C(Cys-C)、脂蛋白(a)[lp(a)]、B型钠尿肽(BNP)、超敏C反应蛋白(hs-CRP)与冠脉综合征急性期(ACS)的相关性。方法:选取本院2015年1月～2017年1月间收治的84例ACS患者纳入本次研究,将入选患者根据具体病理表现划分为急性ST段抬高心肌梗塞(STEMI)组、急性非ST段抬高心肌梗塞(NSTEMI)组、不稳定型心绞痛(UAP)组,依据病变支数将急性期患者划分为单支组、双支组及三支组三个组,对比各组间上述四项指标表达水平并进行相关性分析。结果:各组间四项指标均具有统计学差异,P<0.05。BNP、hs-CRP与ACS诊断间具有高度正相关性,Lp(a)与ACS诊断间具有中度正相关性,Cys-C与ACS不同病变分型间具有低度负相关性,Lp(a)、BNP、hs-CRP与ACS不同病变分型间均具有高度正相关性;P<0.05;四项指标与ACS不同病变范围间均具有高度正相关性,P<0.05。cTnI与四项指标间均具有高度正相关性,Gensini冠脉狭窄程度与hs-CRP具有中度正相关性,与Cys-C、BNP、Lp(a)间均具有高度正相关性。结论:冠脉综合征急性期患者血清Cys-C、Lp(a)、BNP、hs-CRP表达水平可见显著升高,其升高程度与具体的病理表现、冠脉血管狭窄程度以及病变支数均具有明确相关性。
Objective: To study the relationship between serum cystatin C(Cys-C), lipoprotein(a), [lp(a)], type B natriuretic peptide(BNP), high sensitive C reactive protein(hs-CRP) and the acute phase of coronary syndrome(ACS). Methods: 84 ACS patients from January 2015 to January 2017 in our hospital were enrolled in this study and according to the specific pathology divided into acute ST elevation myocardial infarction(STEMI) group, acute non ST elevation myocardial infarction(NSTEMI) group and unstable angina(UAP) group. Then they were further divided into single vessel group, double vessel group and three group of three groups according to the lesion number in acute stage. On the basis of the above four indicators expression levels and correlation analysis were compared. Results: There were significant differences between the four indexes in each group(P<0.05). There were highly positive correlation between BNP, hs-CRP and ACS in diagnosis(P<0.05), moderate positive correlation berween Lp(a) and the diagnosis of ACS, and low negative correlation between Cys-C and ACS in different pathological types(P<0.05). Lp(a), BNP, hs-CRP and ACS in different pathological types were highly positive correlated between the four indexes(P<0.05). There was a high positive correlation between cTnI and four indexes(P<0.05), and the degree of coronary stenosis in Gensini was positively correlated with hs-CRP, and positively correlated with Cys-C, BNP and Lp(a). Conclusion: Serum Cys-C, Lp,BNP, hs-CRP expression levels in patients with acute coronary syndrome significantly increased, and the increased level of specific pathological manifestations, the extent of coronary artery stenosis and the lesions had clear correlation.
Objective: To study the relationship between serum cystatin C(Cys-C), lipoprotein(a), [lp(a)], type B natriuretic peptide(BNP), high sensitive C reactive protein(hs-CRP) and the acute phase of coronary syndrome(ACS). Methods: 84 ACS patients from January 2015 to January 2017 in our hospital were enrolled in this study and according to the specific pathology divided into acute ST elevation myocardial infarction(STEMI) group, acute non ST elevation myocardial infarction(NSTEMI) group and unstable angina(UAP) group. Then they were further divided into single vessel group, double vessel group and three group of three groups according to the lesion number in acute stage. On the basis of the above four indicators expression levels and correlation analysis were compared. Results: There were significant differences between the four indexes in each group(P<0.05). There were highly positive correlation between BNP, hs-CRP and ACS in diagnosis(P<0.05), moderate positive correlation berween Lp(a) and the diagnosis of ACS, and low negative correlation between Cys-C and ACS in different pathological types(P<0.05). Lp(a), BNP, hs-CRP and ACS in different pathological types were highly positive correlated between the four indexes(P<0.05). There was a high positive correlation between cTnI and four indexes(P<0.05), and the degree of coronary stenosis in Gensini was positively correlated with hs-CRP, and positively correlated with Cys-C, BNP and Lp(a). Conclusion: Serum Cys-C, Lp,BNP, hs-CRP expression levels in patients with acute coronary syndrome significantly increased, and the increased level of specific pathological manifestations, the extent of coronary artery stenosis and the lesions had clear correlation.
引文
[1] 李杰.老年急性冠脉综合征患者血清MMP-9、NT-proBNP和hs-CRP水平与冠状动脉病变程度的关系[J].中国老年学杂志,2013,33(13):3221-3222.
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[3] 徐海燕,陈雨,蒙涛,等.胱抑素C和N末端B型利钠肽原评估非ST段抬高型急性冠脉综合征预后的价值[J].心血管康复医学杂志,2016,25(1):88-93.
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[5] 李妍,肖婷,李琳,等.老年急性冠脉综合征患者血清胱抑素C和同型半胱氨酸水平与冠状动脉Gensini评分的相关性[J].中国老年学杂志,2016,56(33):5-7.
[6] Wu Y,Huang Y,Huy,et al.Hyperhomocysteinemia is an independent risk factor in young patients with coronary artery disease in southern China[J].Herz,2013,38(7):779-784.
[7] 韩笑,吴敏,韩素霞.脂蛋白(a)与急性冠脉综合征关系的研究进展[J].世界最新医学信息文摘,2016,16(71):35,40.
[8] Gravning J,Smedsrud MK,Omland T,et al.Sensitive troponin assays and N-terminal pro-B-type natriuretic peptide in acute coronary syndrome:prediction of significant coronary lesions and long-term prognosis[J].Am Heart J,2013,165(5):716-724.
[9] 薛国华,马惠芳,张守彦.非ST段抬高型急性冠脉综合征患者血清Hcy、hs-CRP与冠状动脉斑块易损性的关系[J].实用医学杂志,2016,32(19):3241-3244.
[10] hs-CRP 水平与冠状动脉病变程度的关系[J].中国老年学杂志,2013,33(13):3221-3222.
[2] Esteghamatt A,Hafezi-Nejad N,Zandieh A,et al.Homocysteine and metabolic syndrome:from clustering to additional utility in prediction of coronary heart disease[J].J Cardiol,2014,64(4):290-296.
[3] 徐海燕,陈雨,蒙涛,等.胱抑素C和N末端B型利钠肽原评估非ST段抬高型急性冠脉综合征预后的价值[J].心血管康复医学杂志,2016,25(1):88-93.
[4] 吴礼锋,邹跃玲,闫绍荣,急性冠脉综合征患者超敏C-反应蛋白、肌钙蛋白I、脑钠肽水平变化及临床意义分析[J].中国卫生检验杂志,2017,27(5):692-694.
[5] 李妍,肖婷,李琳,等.老年急性冠脉综合征患者血清胱抑素C和同型半胱氨酸水平与冠状动脉Gensini评分的相关性[J].中国老年学杂志,2016,56(33):5-7.
[6] Wu Y,Huang Y,Huy,et al.Hyperhomocysteinemia is an independent risk factor in young patients with coronary artery disease in southern China[J].Herz,2013,38(7):779-784.
[7] 韩笑,吴敏,韩素霞.脂蛋白(a)与急性冠脉综合征关系的研究进展[J].世界最新医学信息文摘,2016,16(71):35,40.
[8] Gravning J,Smedsrud MK,Omland T,et al.Sensitive troponin assays and N-terminal pro-B-type natriuretic peptide in acute coronary syndrome:prediction of significant coronary lesions and long-term prognosis[J].Am Heart J,2013,165(5):716-724.
[9] 薛国华,马惠芳,张守彦.非ST段抬高型急性冠脉综合征患者血清Hcy、hs-CRP与冠状动脉斑块易损性的关系[J].实用医学杂志,2016,32(19):3241-3244.
[10] hs-CRP 水平与冠状动脉病变程度的关系[J].中国老年学杂志,2013,33(13):3221-3222.