CHE水平与ACS的临床分型以及冠状动脉狭窄程度的相关性
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摘要
目的研究血清胆碱酯酶(CHE)水平与急性冠状动脉综合征(ACS)的临床分型以及冠状动脉狭窄程度的相关性。方法将该院心血管内科2015年8月至2016年8月诊断为ACS的患者300例作为研究对象。根据ACS的类型分为3组:不稳定性心绞痛组(UAP组,n=100)、非ST段抬高型急性心肌梗死组(NSTEMI组,n=98)、ST段抬高型急性心肌梗死组(STEMI组,n=102)。根据冠状动脉狭窄程度分为3组:轻度狭窄组、中度狭窄组和重度狭窄组。记录所有患者的一般资料,检测生化指标及血清CHE水平,并进行统计分析。结果 UAP组、NSTEMI组、STEMI组的血清CHE水平依次升高,3组间差异有统计学意义(P<0.05)。轻度狭窄组、中度狭窄组和重度狭窄组的血清CHE水平也呈现升高的趋势,3组间差异有统计学意义(P<0.05)。生化指标中,各组患者中低密度脂蛋白和高密度脂蛋白水平差异均有统计学意义(P<0.05)。低密度脂蛋白和血清CHE是ACS分型以及冠状动脉狭窄的相关危险因素。血清CHE与ACS分型呈正相关(r=0.135,P=0.019),血清CHE与冠状动脉狭窄程度也呈正相关(r=0.154,P=0.008)。结论血清CHE水平与ACS的临床分型以及冠状动脉狭窄程度具有相关性,能够在一定程度上反映ACS类型和冠状动脉狭窄程度。
Objective To study the correlation between serum cholinesterase(CHE)level and the clinical classification of ACS and the degree of coronary artery stenosis.Methods Totally 300 patients diagnosed as ACS from August 2015 to August 2016 in the Department of Cardiology in our hospital were selected as the research objects.According to the type of ACS,all patients were divided into three groups:the unstable angina group(UAP group,n=100),the non ST segment elevation acute myocardial infarction group(NSTEMI group,n=98),and the ST elevation acute myocardial infarction group(STEMI group,n=102).According to the degree of coronary stenosis,all patients were divided into three groups:mild stenosis group,moderate stenosis group and severe stenosis group.The general data of all patients were recorded,biochemical indexes and serum CHE levels were detected and statistical analysis was carried out.Results The level of serum CHE in UAP group,NSTEMI group and STEMI group increased in turn,and the difference between the three groups was statistically significant(P<0.05).The level of serum CHE in the mild stenosis group,the moderate stenosis group and the severe stenosis group also showed a rising trend,and the difference between the three groups was statistically significant(P<0.05).In the biochemical indexes,the levels of low density lipoprotein(LDL)and high density lipoprotein(HDL)were different in all the patients(P<0.05).LDL and serum CHE were associated risk factors for ACS typing and arterial stenosis.There was a positive correlation between the serum CHE level and the ACS typing(r=0.135,P=0.019),and the serum CHE level was also positively correlated with the degree of coronary stenosis(r=0.154,P=0.008).Conclusion The level of serum CHE is correlated with the clinical classification of ACS and the degree of coronary artery stenosis.It can reflect ACS type and degree of coronary artery stenosis to a certain extent.
Objective To study the correlation between serum cholinesterase(CHE)level and the clinical classification of ACS and the degree of coronary artery stenosis.Methods Totally 300 patients diagnosed as ACS from August 2015 to August 2016 in the Department of Cardiology in our hospital were selected as the research objects.According to the type of ACS,all patients were divided into three groups:the unstable angina group(UAP group,n=100),the non ST segment elevation acute myocardial infarction group(NSTEMI group,n=98),and the ST elevation acute myocardial infarction group(STEMI group,n=102).According to the degree of coronary stenosis,all patients were divided into three groups:mild stenosis group,moderate stenosis group and severe stenosis group.The general data of all patients were recorded,biochemical indexes and serum CHE levels were detected and statistical analysis was carried out.Results The level of serum CHE in UAP group,NSTEMI group and STEMI group increased in turn,and the difference between the three groups was statistically significant(P<0.05).The level of serum CHE in the mild stenosis group,the moderate stenosis group and the severe stenosis group also showed a rising trend,and the difference between the three groups was statistically significant(P<0.05).In the biochemical indexes,the levels of low density lipoprotein(LDL)and high density lipoprotein(HDL)were different in all the patients(P<0.05).LDL and serum CHE were associated risk factors for ACS typing and arterial stenosis.There was a positive correlation between the serum CHE level and the ACS typing(r=0.135,P=0.019),and the serum CHE level was also positively correlated with the degree of coronary stenosis(r=0.154,P=0.008).Conclusion The level of serum CHE is correlated with the clinical classification of ACS and the degree of coronary artery stenosis.It can reflect ACS type and degree of coronary artery stenosis to a certain extent.
引文
[1]王静,李启富,程庆丰.血清胆碱酯酶与2型糖尿病并发症的关系研究[J].中国糖尿病杂志,2012,30(1):48-50.
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[10]SATO T,YAMAUCHI H,SUZUKI S,et al.Serum cholinesterase is an important prognostic factor in chronic heart failure[J].Heart Vessels,2015,30(2):204-210.
[11]崔兆娜,宁莉,吴万通.血清胆碱酯酶活性检测在糖尿病合并冠心病临床应用[J].国际检验医学杂志,2016,37(1):40-44.
[12]黄婷,马小楠,邓娓娓.糖脂代谢紊乱人群血清胆碱酯酶的变化[J].中国医师杂志,2014,16(4):479-481.
[13]张春芳,李政伟,栾毅.血清胆碱酯酶水平与急性冠脉综合征的相关性分析[J].临床检验杂志,2017,35(8):615-617.
[14]SUN L,QI X,TAN Q,et al.Low serum-butyrylcholinesteraseactivity as aprognostic marker of mortality associates with poor cardiac function inacute myocardial infarction[J].Clin Lab,2016,62(6):1093-1099.
[15]朱龙,许航,叶燕锐,等.丁酰胆碱酯酶抑制剂对急性高血脂小鼠模型血脂的影响[J].中华实验外科杂志,2016,33(7):1797-1799.
[2]朱建一,闻平.血清胆碱酯酶和前白蛋白对肝脏合成功能监测的意义[J].临床检验杂志,2004,22(6):458.
[3]张丽,陶红,陈国,等.慢性肺心病急性加重患者血清胆碱酯酶测定的临床意义及预后[J].中西医结合心脑血管病杂志,2013,11(4):429-430.
[4]邓福贵,王彩,贺志安,等.临床医学检验基础[M].北京:人民卫生出版社,2003:85.
[5]YANG G,WANG Y,ZENG Y,et al.Rapid health transition in China,1990-2010:findings from the Global Burden of Disease Study 2010[J].Lancet,2013,381(9882):1987-2015.
[6]刘静,李倩.胆碱酯酶与临床相关疾病的研究进展[J].中国实用医学,2014,9(5):258-260.
[7]EMAMI RAZAVI A,BASATI G,VARSHOSAZ J,et al.Association between HDL particles size and myeloperoxidase/paraoxonase-1(MPO/PON1)ratio in patients with acute coronary syndrome[J].Acta Med Iran,2013,51(6):365-371.
[8]GOLIASCH G,HASCHEMI A,MARCULESCU R,et al.Butyrylcholinesteraseactivity predicts long-term survival in patients with coronary artery disease[J].Clin Chem,2012,58(6):1055-1058.
[9]SULZGRUBER P,KOLLER L,EL-HAMID F,et al.Butyrylcholinesterase predicts cardiac mortality in young patients with acute coronary syndrome[J].Wien Klin Wochenschr,2014,126(2):S79-S80.
[10]SATO T,YAMAUCHI H,SUZUKI S,et al.Serum cholinesterase is an important prognostic factor in chronic heart failure[J].Heart Vessels,2015,30(2):204-210.
[11]崔兆娜,宁莉,吴万通.血清胆碱酯酶活性检测在糖尿病合并冠心病临床应用[J].国际检验医学杂志,2016,37(1):40-44.
[12]黄婷,马小楠,邓娓娓.糖脂代谢紊乱人群血清胆碱酯酶的变化[J].中国医师杂志,2014,16(4):479-481.
[13]张春芳,李政伟,栾毅.血清胆碱酯酶水平与急性冠脉综合征的相关性分析[J].临床检验杂志,2017,35(8):615-617.
[14]SUN L,QI X,TAN Q,et al.Low serum-butyrylcholinesteraseactivity as aprognostic marker of mortality associates with poor cardiac function inacute myocardial infarction[J].Clin Lab,2016,62(6):1093-1099.
[15]朱龙,许航,叶燕锐,等.丁酰胆碱酯酶抑制剂对急性高血脂小鼠模型血脂的影响[J].中华实验外科杂志,2016,33(7):1797-1799.