同型半胱氨酸、脂蛋白(a)和糖化清蛋白与冠心病的相关性研究
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摘要
目的探讨同型半胱氨酸(Hcy)、脂蛋白(a)[Lp(a)]和糖化清蛋白(GA)与冠心病的关系。方法收集该院心内科住院的冠心病患者269例作为冠心病组,该院体检科同期健康体检者200例为对照组,联合检测Hcy、Lp(a)、GA血清水平,并进行比较分析。结果分析发现,冠心病组Hcy、Lp(a)、GA血清水平明显高于对照组,差异均有统计学意义(P<0.05);冠心病组Hcy、Lp(a)、GA 3个指标单独检测阳性率及联合检测阳性率明显高于对照组,差异均有统计学意义(P<0.05);Pearson相关分析结果显示,冠心病发生率与Hcy、Lp(a)、GA水平呈正相关(P<0.05),相关系数分别为0.563、0.554、0.631;Logistic多因素回归分析显示,Hcy(OR=1.755,95%CI:1.156～1.675)、Lp(a)(OR=2.069,95%CI:1.867～3.954)、GA(OR=1.634,95%CI:1.025～2.945)三者OR均大于1,说明Hcy、Lp(a)、GA都是冠心病的独立危险因子。结论 Hcy、Lp(a)和GA三者联合检测对冠心病预防、临床疾病筛检、罹患风险评估有良好的参考价值。
Objective To explore the relationship between homocysteine(Hcy),lipoprotein(a)[Lp(a)]and glycated albumin(GA)with coronary heart disease(CHD).Methods A total of 269 patients with CHD hospitalized in the cardiology department of this hospital were collected as the CHD group,and contemporaneous 200 subjects undergoing the health physical examination in the department of physical examination were taken as the control group.The levels of serum Hcy,Lp(a)and GA were jointly detected and the results were performed the comparative analysis.Results The serum levels of Hcy,Lp(a)and GA in the CHD group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05);the Pearson correlation analysis showed that the occurrence rate of CHD was positively correlated with the levels of Hcy,Lp(a)and GA(P<0.05),with the correlation coefficients of 0.563,0.554 and 0.631 respectively;the Logistic multivariate regression analysis showed that Hcy(OR=1.755,95%CI:1.156-1.675),Lp(a)(OR=2.069,95%CI:1.867-3.954),GA(OR=1.634,95%CI:1.025-2.945),their OR were all above1,indicating that Hcy,Lp(a)and GA were the independent risk factors of CHD.Conclusion The combined detection of Hcy,Lp(a)and GA has good reference value for the prevention of CHD,screening of clinical diseases and assessment of risk suffering from CHD.
Objective To explore the relationship between homocysteine(Hcy),lipoprotein(a)[Lp(a)]and glycated albumin(GA)with coronary heart disease(CHD).Methods A total of 269 patients with CHD hospitalized in the cardiology department of this hospital were collected as the CHD group,and contemporaneous 200 subjects undergoing the health physical examination in the department of physical examination were taken as the control group.The levels of serum Hcy,Lp(a)and GA were jointly detected and the results were performed the comparative analysis.Results The serum levels of Hcy,Lp(a)and GA in the CHD group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05);the Pearson correlation analysis showed that the occurrence rate of CHD was positively correlated with the levels of Hcy,Lp(a)and GA(P<0.05),with the correlation coefficients of 0.563,0.554 and 0.631 respectively;the Logistic multivariate regression analysis showed that Hcy(OR=1.755,95%CI:1.156-1.675),Lp(a)(OR=2.069,95%CI:1.867-3.954),GA(OR=1.634,95%CI:1.025-2.945),their OR were all above1,indicating that Hcy,Lp(a)and GA were the independent risk factors of CHD.Conclusion The combined detection of Hcy,Lp(a)and GA has good reference value for the prevention of CHD,screening of clinical diseases and assessment of risk suffering from CHD.
引文
[1]张琛涛,莫新玲.冠心病、高血压与血清同型半胱氨酸、超敏C反应蛋白的相关性[J].中国老年学杂志,2013,33(5):1035-1037.
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[4]鲍巧玲.血清CRP、Hcy、LP(a)、D-二聚体联合检测对冠心病的临床诊断价值[J].国际检验医学杂志,2018,39(1):77-79.
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[8]郝亚平,马晓静,周密,等.糖化血清白蛋白与冠心病的相关性研究[J].中华医学杂志,2012,92(30):2095.
[9]田磊,米树华,周芸,等.冠心病合并糖代谢异常患者临床及冠状动脉病变特点分析[J].中华实用诊断与治疗杂志,2013,27(1):42-44.
[10]李玉敏,齐振生,姚淑艳,等.HCY、DD与hs-CRP等生化指标在冠心病诊断价值的探讨[J].中国实验诊断学,2016,20(4):646-649.
[11]李霞,罗维.冠心病患者疾病相关知识现状及影响因素的调查分析[J].重庆医学,2011,40(6):594-595.
[12]任红玲,刘峰,于宏亮.血清同型半胱氨酸与冠心病的相关性研究[J].中国医药指南,2017,15(20):31-32.
[13]薛燕平,李玲,任倩,等.血浆同型半胱氨酸与脑梗死动脉粥样硬化相关性分析[J].中华实用诊断与治疗杂志,2010,24(5):465-466.
[14]尹俊萍,翟淑景.糖化白蛋白和同型半胱氨酸与冠心病的关系分析[J].河北医药,2015,37(4):534-535.
[15]吴志勤,陈庆伟,吴庆,等.血清脂蛋白a与冠心病的研究[J].重庆医科大学学报,2011,36(11):1356-1360.
[16]王冰,王玉明,段勇.糖化血清白蛋白分子特性及临床意义[J].实验与检验医学,2015,33(6):693-696.
[17]高胜利,周秀丽,伍熙,等.血清糖化白蛋白和同型半胱氨酸与冠状动脉病变的相关性[J].中华实用诊断与治疗杂志,2014,28(9):886-888.
[18]SHIM E,BABU J P.Glycated albumin produced in diabetic hyperglycemia promotes monocyte secretion of inflammatory cytokines and bacterial adherence to epithelial cells[J].J Periodontal Res,2015,50(2):197-204.
[19]赵伟林,杨帆,员丽培,等.血清同型半胱氨酸及脂蛋白(a)与冠心病的相关性研究[J].中国循证心血管医学杂志,2015,7(2):229-231.
[20]杨朝娣,王素青,习广燕.3种指标在冠心病合并心力衰竭诊治中的应用及相关性研究[J].国际检验医学杂志,2017,38(18):2526-2528.
[2] ZHU K F,WANG Y M,ZHU J Z,et al.National prevalence of coronary heart disease and its relationship with human development index:a systematic review[J].Eur J Prev Cardiol,2016,23(5):530-543.
[3]王波,王临池,赵翼洪,等.2009-2013年苏州20岁及以上居民冠心病发病率变化趋势及类型分析[J].中国全科医学,2015,18(24):2952-2956.
[4]鲍巧玲.血清CRP、Hcy、LP(a)、D-二聚体联合检测对冠心病的临床诊断价值[J].国际检验医学杂志,2018,39(1):77-79.
[5] WANG J J,ZHANG C N,MENG Y,et al.Elevated concentrations of oxidized lipoprotein(a)are associated with the presence and severity of acute coronary syndromes[J].Clinica Chimica Acta,2009,408(1/2):79-82.
[6] LIPPI G,TARGHER G,FRANCHINI M,et al.Biochemical correlates of lipoprotein(a)in a general adult population.Possible implications for cardiovascular risk assessment[J].J Thromb Thrombolysis,2009,27(1):44-47.
[7]江丽霞,钟星明,施少华,等.同型半胱氨酸和脂蛋白(a)联合检测与冠心病的相关性研究[J].检验医学,2012,27(11):924-928.
[8]郝亚平,马晓静,周密,等.糖化血清白蛋白与冠心病的相关性研究[J].中华医学杂志,2012,92(30):2095.
[9]田磊,米树华,周芸,等.冠心病合并糖代谢异常患者临床及冠状动脉病变特点分析[J].中华实用诊断与治疗杂志,2013,27(1):42-44.
[10]李玉敏,齐振生,姚淑艳,等.HCY、DD与hs-CRP等生化指标在冠心病诊断价值的探讨[J].中国实验诊断学,2016,20(4):646-649.
[11]李霞,罗维.冠心病患者疾病相关知识现状及影响因素的调查分析[J].重庆医学,2011,40(6):594-595.
[12]任红玲,刘峰,于宏亮.血清同型半胱氨酸与冠心病的相关性研究[J].中国医药指南,2017,15(20):31-32.
[13]薛燕平,李玲,任倩,等.血浆同型半胱氨酸与脑梗死动脉粥样硬化相关性分析[J].中华实用诊断与治疗杂志,2010,24(5):465-466.
[14]尹俊萍,翟淑景.糖化白蛋白和同型半胱氨酸与冠心病的关系分析[J].河北医药,2015,37(4):534-535.
[15]吴志勤,陈庆伟,吴庆,等.血清脂蛋白a与冠心病的研究[J].重庆医科大学学报,2011,36(11):1356-1360.
[16]王冰,王玉明,段勇.糖化血清白蛋白分子特性及临床意义[J].实验与检验医学,2015,33(6):693-696.
[17]高胜利,周秀丽,伍熙,等.血清糖化白蛋白和同型半胱氨酸与冠状动脉病变的相关性[J].中华实用诊断与治疗杂志,2014,28(9):886-888.
[18]SHIM E,BABU J P.Glycated albumin produced in diabetic hyperglycemia promotes monocyte secretion of inflammatory cytokines and bacterial adherence to epithelial cells[J].J Periodontal Res,2015,50(2):197-204.
[19]赵伟林,杨帆,员丽培,等.血清同型半胱氨酸及脂蛋白(a)与冠心病的相关性研究[J].中国循证心血管医学杂志,2015,7(2):229-231.
[20]杨朝娣,王素青,习广燕.3种指标在冠心病合并心力衰竭诊治中的应用及相关性研究[J].国际检验医学杂志,2017,38(18):2526-2528.