急性冠脉综合征患者超敏C反应蛋白、同型半胱氨酸、血尿酸及T细胞亚群水平变化及其意义
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摘要
目的探讨急性冠脉综合征(ACS)患者超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、血尿酸(UA)水平及T细胞亚群的表达意义。方法选取2017年1月-2018年1月收治的ACS患者70例进行研究,依据病情分为不稳定型心绞痛(UAP组)、急性心肌梗死(AMI组),另选取同期健康体检者35例作为对照组。采集ACS患者入院次日清晨及对照组清晨空腹静脉血,采用免疫比浊法检测血清hs-CRP,ELISA法检测血清中Hcy水平,全自动生化分析仪检测UA水平,采用流式细胞仪检测CD_4~+CD_(25)~+调节性T细胞(CD_4~+CD_(25)~+Treg)、高表达CD_(25)的CD4T细胞亚群(CD4~+CD_(25)~(highTreg))。结果 UAP组、AMI组患者hs-CRP、Hcy、UA水平均高于对照组(P均<0.05),AMI组hs-CRP、Hcy、UA水平均高于UAP组(P均<0.05);UAP组、AMI组患者CD_4~+CD_(25)~+Treg、CD4~+CD_(25)~(highTreg)均低于对照组(P均<0.05),AMI组CD_4~+CD_(25)~+Treg、CD_4~+CD_(25)~(highTreg)均低于UAP组(P均<0.05)。结论 ACS患者存在hs-CRP、Hcy、UA水平异常升高及免疫功能降低,临床联合检测对ACS的早期诊断、病变评估具有重要意义。
Objective To investigate the expression of C-reactive protein(hs-CRP),homocysteine(Hcy),serum uric acid(UA)and T cell subsets in patients with acute coronary syndrome(ACS). Methods A total of 70 patients with ACS who were admitted in our hospital from January,2017 to January,2018 were included in the study and divided into unstable angina pectoris(UAP)group and acute myocardial infarction(AMI)group according to the disease conditions. Moreover,the healthy individuals were served as the control group. The morning fasting venous blood for ACS patients the day after admission and the control group was collected. The immunoturbidimetric assay was used to detect the serum hs-CRP. ELISA was used to detect the serum Hcy level. The full automatic biochemical analyzer was used to detect UA level. FCM was used to detect CD4~+CD25~+Treg and CD4~+CD_(25~(highTreg). Results The levels of hs-CRP,Hcy,and UA in UAP and AMI groups were significantly higher than those in the control group(P<0.05),while hs-CRP,Hcy,and UA levels in AMI group were significantly higher than those in UAP group(P<0.05). CD4~+CD_(25)~+Treg and CD_4~+CD_(25)~(highTreg) in UAP and AMI groups were significantly lower than those in the control group(P<0.05),while CD_4~+CD_(25)~+Treg and CD_4~+CD_(25)~(highTreg) in AMI group were significantly lower than those in UAP group(P<0.05). Conclusion Due to the abnormal elevation of hs-CRP,Hcy,and UA levels and the reduction of immune function in patients with ACS,the combined detection is of great significance in the early diagnosis and lesion assessment of ACS.
Objective To investigate the expression of C-reactive protein(hs-CRP),homocysteine(Hcy),serum uric acid(UA)and T cell subsets in patients with acute coronary syndrome(ACS). Methods A total of 70 patients with ACS who were admitted in our hospital from January,2017 to January,2018 were included in the study and divided into unstable angina pectoris(UAP)group and acute myocardial infarction(AMI)group according to the disease conditions. Moreover,the healthy individuals were served as the control group. The morning fasting venous blood for ACS patients the day after admission and the control group was collected. The immunoturbidimetric assay was used to detect the serum hs-CRP. ELISA was used to detect the serum Hcy level. The full automatic biochemical analyzer was used to detect UA level. FCM was used to detect CD4~+CD25~+Treg and CD4~+CD_(25~(highTreg). Results The levels of hs-CRP,Hcy,and UA in UAP and AMI groups were significantly higher than those in the control group(P<0.05),while hs-CRP,Hcy,and UA levels in AMI group were significantly higher than those in UAP group(P<0.05). CD4~+CD_(25)~+Treg and CD_4~+CD_(25)~(highTreg) in UAP and AMI groups were significantly lower than those in the control group(P<0.05),while CD_4~+CD_(25)~+Treg and CD_4~+CD_(25)~(highTreg) in AMI group were significantly lower than those in UAP group(P<0.05). Conclusion Due to the abnormal elevation of hs-CRP,Hcy,and UA levels and the reduction of immune function in patients with ACS,the combined detection is of great significance in the early diagnosis and lesion assessment of ACS.
引文
[1]许浩,杨汉东,闵新文,等.急性冠脉综合征急诊PCI心血管不良事件与血清肌钙蛋白水平的关系[J].海南医学,2016,27(1):32-34.
[2]毕惠珍,刘润霞,朱道华,等.急性冠脉综合征患者医院感染的相关高危因素分析[J].中华医院感染学杂志,2015,25(1):146-148.
[3]石清,程康,田季雨.丹参多酚酸盐联合氯吡格雷对急性冠脉综合征病人心功能、内皮功能、炎症因子的影响[J].中西医结合心脑血管病杂志,2017,15(23):3026-3029.
[4]杨新春.急性冠脉综合征基础与临床[M].北京:人民军医出版社,2003:5-6.
[5]谢秀峰,陈没英,崔晓迎,等.急性冠脉综合征从发病到早期诊断的影响因素分析[J].内蒙古医学杂志,2016,48(7):769-772.
[6]贾国伟.急性冠脉综合征PCI术后患者应用替格瑞洛及氯吡格雷治疗的临床效果比较[J].中国医药导刊,2016,18(2):181-183.
[7]卫颖,杨明环,徐英.组织多普勒联合心肌酶在急性冠脉综合征患者中的诊断价值研究[J].现代医学影像学,2017,26(2):295-297.
[8]张倩辉,王立立,张志梅,等.不同剂量阿托伐他汀对ACS征患者PCI术后血清cTnI、NT-proBNP及心肌酶谱的影响[J].疑难病杂志,2017,16(12):1193-1196,1200.
[9]徐林杰,吴继雄,许邦龙,等.急性冠脉综合征患者外周血CD4+CD25+CD127low调节性T细胞的变化及意义[J].安徽医科大学学报,2014,49(5):637-640.
[10]王品晓,张云霞,项晓觉,等.急性冠脉综合征患者血尿酸水平变化及与同型半胱氨酸、T细胞亚群、血脂的关系研究[J].中华全科医学,2017,15(9):1512-1514.
[11]王文会,赵华云,陈伟强,等.益气舒心丸对急性冠脉综合征患者内皮功能、相关炎症因子和P-选择素的影响[J].中医药导报,2016,22(10):73-75.
[12]吴桂玲,戴晓宁.超敏C-反应蛋白、同型半胱氨酸、D-二聚体的水平与急性冠脉综合征的相关性[J].当代医药论丛,2017,15(5):126-127.
[13]贺帅,赵伟.hs-CRP、Hcy、IMA、H-FABP检测对急性冠脉综合征危险分层的意义[J].中国循证心血管医学杂志,2017,9(6):730-731.
[14]陈志成.同型半胱氨酸与急性冠脉综合征的相关性临床研究[J].现代诊断与治疗,2015,26(6):1311-1312.
[15]初青莲,曲绍霞,邵长宝.老年急性冠脉综合征患者冠脉病变与血清胱抑素尿酸的相关性分析[J].河北医学,2014,20(2):227-229.
[2]毕惠珍,刘润霞,朱道华,等.急性冠脉综合征患者医院感染的相关高危因素分析[J].中华医院感染学杂志,2015,25(1):146-148.
[3]石清,程康,田季雨.丹参多酚酸盐联合氯吡格雷对急性冠脉综合征病人心功能、内皮功能、炎症因子的影响[J].中西医结合心脑血管病杂志,2017,15(23):3026-3029.
[4]杨新春.急性冠脉综合征基础与临床[M].北京:人民军医出版社,2003:5-6.
[5]谢秀峰,陈没英,崔晓迎,等.急性冠脉综合征从发病到早期诊断的影响因素分析[J].内蒙古医学杂志,2016,48(7):769-772.
[6]贾国伟.急性冠脉综合征PCI术后患者应用替格瑞洛及氯吡格雷治疗的临床效果比较[J].中国医药导刊,2016,18(2):181-183.
[7]卫颖,杨明环,徐英.组织多普勒联合心肌酶在急性冠脉综合征患者中的诊断价值研究[J].现代医学影像学,2017,26(2):295-297.
[8]张倩辉,王立立,张志梅,等.不同剂量阿托伐他汀对ACS征患者PCI术后血清cTnI、NT-proBNP及心肌酶谱的影响[J].疑难病杂志,2017,16(12):1193-1196,1200.
[9]徐林杰,吴继雄,许邦龙,等.急性冠脉综合征患者外周血CD4+CD25+CD127low调节性T细胞的变化及意义[J].安徽医科大学学报,2014,49(5):637-640.
[10]王品晓,张云霞,项晓觉,等.急性冠脉综合征患者血尿酸水平变化及与同型半胱氨酸、T细胞亚群、血脂的关系研究[J].中华全科医学,2017,15(9):1512-1514.
[11]王文会,赵华云,陈伟强,等.益气舒心丸对急性冠脉综合征患者内皮功能、相关炎症因子和P-选择素的影响[J].中医药导报,2016,22(10):73-75.
[12]吴桂玲,戴晓宁.超敏C-反应蛋白、同型半胱氨酸、D-二聚体的水平与急性冠脉综合征的相关性[J].当代医药论丛,2017,15(5):126-127.
[13]贺帅,赵伟.hs-CRP、Hcy、IMA、H-FABP检测对急性冠脉综合征危险分层的意义[J].中国循证心血管医学杂志,2017,9(6):730-731.
[14]陈志成.同型半胱氨酸与急性冠脉综合征的相关性临床研究[J].现代诊断与治疗,2015,26(6):1311-1312.
[15]初青莲,曲绍霞,邵长宝.老年急性冠脉综合征患者冠脉病变与血清胱抑素尿酸的相关性分析[J].河北医学,2014,20(2):227-229.