多指标联合监测在冠心病早期诊断中的应用评价
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摘要
目的探讨多指标联合监测在冠心病(CHD)早期临床诊断中的应用。方法选取2017年1月～2017年12月在我院就诊的CHD患者150例为观察组,根据冠状动脉造影检查结果分为单支病变46例、双支病变55例、多支病变49例。按照冠状动脉狭窄程度将患者分为轻度狭窄31例、中度狭窄43例、重度狭窄48例和完全闭塞28例。另选取健康体检者50例为对照组。比较不同血管病变、不同冠状动脉狭窄程度的CHD患者血清游离脂肪酸(FFA)、高敏C反应蛋白(hs-CRP)、尿β-2微球蛋白(β_2-MG)、血清25羟维生素D_3(25-(OH)2-VitD_3)及血脂水平变。结果与单支病变比较,双支、多支病变患者血清FFA、hs-CRP、β_2-MG、TC、TG、LDL-C水平逐渐升高,25-(OH)2-VitD_3、HDL-C水平逐渐降低,差异有统计学意义(P<0.05);与轻度狭窄比较中度、重度狭窄和完全闭塞患者血清FFA、hs-CRP、β_2-MG、TC、TG、LDL-C水平逐渐升高,25-(OH)2-VitD_3、HDL-C水平逐渐降低,差异有统计学意义(P<0.05)。结论多指标联合检测对于早期诊断冠心病患者有一定意义。
Objective To explore the application of multi-index combined monitoring in the early clinical diagnosis of coronary heart disease(CHD).Methods 150 patients with CHD were selected from January 2017 to December 2017 were selected as observation group,According to the results of coronary angiography,there were 46 cases of single vessel disease,55 cases of double vessel disease and 49 cases of multiple vessel disease.According to the degree of coronary artery stenosis,the patients were divided into 31 cases of mild stenosis,43 cases of moderate stenosis,48 cases of severe stenosis and 28 cases of complete occlusion.Another 50 healthy people were selected as the control group.The changes of serum free fatty acid(FFA),high-sensitivity C-reactive protein(hs-CRP),urinary beta-2 microglobulin(beta-2-MG),serum 25-hydroxyvitamin D_3(25-(OH)2-VitD_3) and blood lipid levels were compared in CHD patients with different vascular lesions and different degrees of coronary artery stenosis.Results Compared with single vessel disease,serum FFA,hs-CRP,beta-2-MG,TC,TG and LDL-C levels in patients with double or multiple vessel disease increased gradually,while serum 25-(OH)2-VitD_3 and HDL-C levels decreased gradually(P<0.05);serum FFA,hs-CRP,beta-2-MG,TC,TG and LDL-C levels in patients with moderate or severe stenosis and complete occlusion increased gradually,while serum 25-(OH)2-MG,HDL-C levels decreased gradually(P<0.05).Conclusion The combined detection of multiple indicators has certain signi?cance for the early diagnosis of coronary heart disease.
Objective To explore the application of multi-index combined monitoring in the early clinical diagnosis of coronary heart disease(CHD).Methods 150 patients with CHD were selected from January 2017 to December 2017 were selected as observation group,According to the results of coronary angiography,there were 46 cases of single vessel disease,55 cases of double vessel disease and 49 cases of multiple vessel disease.According to the degree of coronary artery stenosis,the patients were divided into 31 cases of mild stenosis,43 cases of moderate stenosis,48 cases of severe stenosis and 28 cases of complete occlusion.Another 50 healthy people were selected as the control group.The changes of serum free fatty acid(FFA),high-sensitivity C-reactive protein(hs-CRP),urinary beta-2 microglobulin(beta-2-MG),serum 25-hydroxyvitamin D_3(25-(OH)2-VitD_3) and blood lipid levels were compared in CHD patients with different vascular lesions and different degrees of coronary artery stenosis.Results Compared with single vessel disease,serum FFA,hs-CRP,beta-2-MG,TC,TG and LDL-C levels in patients with double or multiple vessel disease increased gradually,while serum 25-(OH)2-VitD_3 and HDL-C levels decreased gradually(P<0.05);serum FFA,hs-CRP,beta-2-MG,TC,TG and LDL-C levels in patients with moderate or severe stenosis and complete occlusion increased gradually,while serum 25-(OH)2-MG,HDL-C levels decreased gradually(P<0.05).Conclusion The combined detection of multiple indicators has certain signi?cance for the early diagnosis of coronary heart disease.
引文
[1]周学中,王惠,罗太阳.经皮冠脉介入治疗老年冠心病患者的预后及其影响因素[J].江苏大学学报(医学版),2018,28(6):512-515.
[2]艾聪,李娟,张珊姗,等.辽宁农村地区2009-2015年冠心病死亡趋势及早死所致疾病负担研究[J].中华疾病控制杂志,2018,22(11):1106-1109.
[3]LiuJ,LiuH,ZhaoH,etal.Descriptive studyof relationship Betweencardio-anklevascular indexation and biomarkers invascular-Related diseases[J].Clin ExpHypertens,2017,39(5):468-472.
[4]CioniG,MarcucciR,GoriAM,etal.Increased homocysteine Andlipoprotein(a)level shighlight system atherosclerotic Burdenin patientswithahistory of acutecoronary syndromes JVascSurg,2016,64(1):163-170.
[5]王维铁,张旭,许日昊,等.冠心病患者冠状动脉病变程度与颈动脉粥样硬化及脑梗死的关系[J].中国动脉硬化杂志,2017,25(2):171-174.
[6]吴舒窈,刘艳,宋倩.冠心病发病及预后的影响因素研究[J].中国全科医学,2018,21(29):3562-3570.
[7]KimIY,HwangIH,Lee KN,etal.Decreased Renal Function Isan Independent Predictor of Severityof Coronary Artery Disease:An Application of Gensini Score[J].J Korean MedSci,2013,28(11):1615-1621.
[8]Jastrzebski,Zbigniew,Kortas,Jakub,Kaczor,Katarzyna,et al.Vitamin D Supplementation Causes a Decrease in Blood Cholesterol in Professional Rowers[J].Journal of Nutritional Science and Vitaminology,2016,62(2):88-92.
[2]艾聪,李娟,张珊姗,等.辽宁农村地区2009-2015年冠心病死亡趋势及早死所致疾病负担研究[J].中华疾病控制杂志,2018,22(11):1106-1109.
[3]LiuJ,LiuH,ZhaoH,etal.Descriptive studyof relationship Betweencardio-anklevascular indexation and biomarkers invascular-Related diseases[J].Clin ExpHypertens,2017,39(5):468-472.
[4]CioniG,MarcucciR,GoriAM,etal.Increased homocysteine Andlipoprotein(a)level shighlight system atherosclerotic Burdenin patientswithahistory of acutecoronary syndromes JVascSurg,2016,64(1):163-170.
[5]王维铁,张旭,许日昊,等.冠心病患者冠状动脉病变程度与颈动脉粥样硬化及脑梗死的关系[J].中国动脉硬化杂志,2017,25(2):171-174.
[6]吴舒窈,刘艳,宋倩.冠心病发病及预后的影响因素研究[J].中国全科医学,2018,21(29):3562-3570.
[7]KimIY,HwangIH,Lee KN,etal.Decreased Renal Function Isan Independent Predictor of Severityof Coronary Artery Disease:An Application of Gensini Score[J].J Korean MedSci,2013,28(11):1615-1621.
[8]Jastrzebski,Zbigniew,Kortas,Jakub,Kaczor,Katarzyna,et al.Vitamin D Supplementation Causes a Decrease in Blood Cholesterol in Professional Rowers[J].Journal of Nutritional Science and Vitaminology,2016,62(2):88-92.