Hcy、CRP、SAA、APN检测在冠状动脉病变严重程度评估中的价值
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摘要
目的探讨同型半胱氨酸(Hcy)、C-反应蛋白(CRP)、脂联素(APN)、血清淀粉样蛋白(SAA)检测在冠状动脉病变严重程度评估中的价值。方法选取该院2016年5月至2018年4月收治的符合纳入标准的行冠状动脉造影术患者240例[冠心病组(n=177)及非冠心病组(n=63)]及同期健康体检者60例(对照组)为研究对象。检测所有研究对象血脂、Hcy、CRP、APN、SAA、可溶性白细胞分化抗原40配体(sCD40L)、纤维蛋白原(Fib)水平,并分析Hcy、CRP、APN及SAA与Gensini积分的相关性。结果冠心病组Hcy、CRP、APN、SAA、高密度脂蛋白胆固醇(HDL-C)、sCD40L、Fib水平与非冠心病组及对照组比较,差异均有统计学意义(P<0.05);Gensini积分越高,患者Hcy、CRP、SAA、sCD40L及Fib水平越高,APN水平越低,差异有统计学意义(P<0.05);冠状动脉病变累积支数越多,患者Hcy、CRP、SAA、sCD40L及Fib水平越高,APN水平越低,差异有统计学意义(P<0.05);经Pearson相关性分析发现,APN、SAA及Fib与Gensini积分具有一定相关性(r=-0.52、0.47、0.63,P<0.05);Hcy、CRP及sCD40L与Gensini积分呈正相关(r=0.27、0.31、0.21,P<0.05)。结论Hcy、CRP、APN、SAA水平与冠状动脉病变程度相关,可用于该病病变程度评估,但仍需进一步验证。
Objective To explore the value of homocysteine(Hcy),C-reactive protein(CRP),adiponectin(APN)and serum amyloid protein(SAA)levels in assessing the severity of coronary artery lesions.Methods A total of 240 cases underwent coronary angiography [CHD group(n=177)and non-CHD group(n=63)]and 54 healthy people in our hospital from May 2016 to April 2018 were selected as subjects.Hcy,CRP,fibrinogen(Fib),serum lipid,APN,SAA,sCD40 Lwere collected and compared.The correlation between Hcy,CRP,APN,SAA,Fib and Gensini score was analyzed.Results The levels of Hcy,CRP,Fib,HDL-C,APN,SAA and sCD40 in CHD group were higher than those in non-CHD group and control group(P<0.05).The higher the Gensini score,the higher the levels of Hcy,CRP,SAA,sCD40 Land Fib,the lower the APN level,and the differences were statistically significant(P<0.05).The more the cumulative number of coronary lesions,the higher the levels of Hcy,CRP,SAA,sCD40 Land Fib,the lower the APN level,the differences were statistically significant(P<0.05).Pearson correlation analysis found that Hcy,CRP and sCD40 Lwere weakly correlated with Gensini score(r=0.27,0.31,0.21,P<0.05).APN,SAA,Fib had moderate correlation with Gensini integral(r=-0.52,0.47,0.63,P<0.05).Conclusion Hcy,CRP,APN and SAA are correlated with the severity of coronary artery lesions,which may be used to assess the severity of coronary artery lesions,but need to be further validated.
Objective To explore the value of homocysteine(Hcy),C-reactive protein(CRP),adiponectin(APN)and serum amyloid protein(SAA)levels in assessing the severity of coronary artery lesions.Methods A total of 240 cases underwent coronary angiography [CHD group(n=177)and non-CHD group(n=63)]and 54 healthy people in our hospital from May 2016 to April 2018 were selected as subjects.Hcy,CRP,fibrinogen(Fib),serum lipid,APN,SAA,sCD40 Lwere collected and compared.The correlation between Hcy,CRP,APN,SAA,Fib and Gensini score was analyzed.Results The levels of Hcy,CRP,Fib,HDL-C,APN,SAA and sCD40 in CHD group were higher than those in non-CHD group and control group(P<0.05).The higher the Gensini score,the higher the levels of Hcy,CRP,SAA,sCD40 Land Fib,the lower the APN level,and the differences were statistically significant(P<0.05).The more the cumulative number of coronary lesions,the higher the levels of Hcy,CRP,SAA,sCD40 Land Fib,the lower the APN level,the differences were statistically significant(P<0.05).Pearson correlation analysis found that Hcy,CRP and sCD40 Lwere weakly correlated with Gensini score(r=0.27,0.31,0.21,P<0.05).APN,SAA,Fib had moderate correlation with Gensini integral(r=-0.52,0.47,0.63,P<0.05).Conclusion Hcy,CRP,APN and SAA are correlated with the severity of coronary artery lesions,which may be used to assess the severity of coronary artery lesions,but need to be further validated.
引文
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[8]张琦,牛文彦,李晓亮,等.急性脑梗死患者血浆Hcy、eNOS、sTM、hs-CRP、vWF的变化及意义[J].山东医药,2015,18(1):17-19.
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[11]程诚,王鑫.冠心病合并2型糖尿病患者PCI术后支架内再狭窄危险因素分析[J].中国循证心血管医学杂志,2018,10(2):196-198.
[12]罗庆慧,苏国海.冠心病患者血清vaspin与脂联素的水平变化及意义[J].山东医药,2018,58(13):69-71.
[13]谢翔,宋长来,吴雪琴,等.SAA遗传多态性与冠心病临床预后的关联研究[J].新疆医科大学学报,2018,41(1):1-5.
[14]刘佳,高洁,马晓娟,等.血栓前状态及血小板聚集率与冠心病危险因素的相关性分析[J].中西医结合心脑血管病杂志,2018,16(5):513-516.
[15]LIU K,HUA BT,GUO T,et al.The assessment of the long-term effects of elective CRT-D of coronary heart disease after PCI[J].Eur Rev Med Pharmacol Sci,2017,21(6):1313-1317.
[2]章祎,王湛,蔡梦娇.血清同型半胱氨酸和超敏C反应蛋白与冠心病、高血压疾病发展的相关性[J].广东医学,2016,37(13):1989-1990.
[3]HE X M,CHEN L,LUO J B,et al.Effects of rhBNP after PCI on non-invasive hemodynamic in acute myocardial infarction patients with left heart failure[J].Asian Pac JTrop Med,2016,9(8):791-795.
[4]WONG M C,ZHANG D X,WANG H H.Rapid emergence of atherosclerosis in Asia:a systematic review of coronary atherosclerotic heart disease epidemiology and implications for prevention and control strategies[J].Curr Opin Lipidol,2015,26(4):257-269.
[5]YANG R H,LIU Y F,WANG X J,et al.Correlation between high density lipoprotein and monocyte subpopulations among stable coronary atherosclerotic heart disease patients[J].Int J Clin Exp Med,2015,8(9):16969.
[6]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-950.
[7]赵振燕,吴永健.2013欧洲心脏病学会(ESC)糖尿病、糖尿病前期及心血管疾病诊疗指南概述[J].中国循环杂志,2013,28(8):572-575.
[8]张琦,牛文彦,李晓亮,等.急性脑梗死患者血浆Hcy、eNOS、sTM、hs-CRP、vWF的变化及意义[J].山东医药,2015,18(1):17-19.
[9]MIGLIONICO M,MANGIACAPRA F,NUSCA A,et al.Efficacy and Safety of Paclitaxel Coated Balloon for the Treatment of In-Stent Restenosis in High-Risk Patients[J].Am J Cardiol,2015,116(11):1690-1694.
[10]HAN X,LIU L,NIU J,et al.Serum VEGF predicts worse clinical outcome of patients with coronary heart disease after percutaneous coronary intervention therapy[J].Med Sci Monit,2015(21):3247-3251.
[11]程诚,王鑫.冠心病合并2型糖尿病患者PCI术后支架内再狭窄危险因素分析[J].中国循证心血管医学杂志,2018,10(2):196-198.
[12]罗庆慧,苏国海.冠心病患者血清vaspin与脂联素的水平变化及意义[J].山东医药,2018,58(13):69-71.
[13]谢翔,宋长来,吴雪琴,等.SAA遗传多态性与冠心病临床预后的关联研究[J].新疆医科大学学报,2018,41(1):1-5.
[14]刘佳,高洁,马晓娟,等.血栓前状态及血小板聚集率与冠心病危险因素的相关性分析[J].中西医结合心脑血管病杂志,2018,16(5):513-516.
[15]LIU K,HUA BT,GUO T,et al.The assessment of the long-term effects of elective CRT-D of coronary heart disease after PCI[J].Eur Rev Med Pharmacol Sci,2017,21(6):1313-1317.