【摘要】 目的观察分析冠心病患者血清超敏C-反应蛋白、胱抑素C水平变化的检验意义,通过了解冠心病患者血清中超敏C-反应蛋白和胱抑素C的水平变化,有利于冠心病的诊治,提高患者的生存率、生存质量,提高治疗有效率,保证冠心病患者的利益。方法选取2013年3月至2015年3月收治的冠心病患者150例作为冠心病组,选取同时期的健康体检患者共75例作为对照组。冠心病组又根据冠脉造影结果分为单支病变组45例,双支病变组50例,多支病变组55例,统计健康对照组患者、冠心病患者及不同病变类型冠心病患者血脂水平、血清超敏C-反应蛋白、胱抑素C水平、同型半胱氨酸和游离脂肪酸水平,分析冠心病患者血清超敏C-反应蛋白、胱抑素C水平和血脂、同型半胱氨酸和游离脂肪酸水平、冠心病患者病情严重程度之间的相关性,分析二者在冠心病患者的临床诊断及治疗中的指导意义。结果 150例冠心病患者中单支病变45例,双支病变50例,多支病变55例。冠心病组患者的超敏C-反应蛋白和胱抑素C水平明显高于对照组受试者,2组比较差异有统计学意义(P<0.05)。而Hcy和FFA水平,对照组也明显低于冠心病组(P<0.05)。不同类型冠心病病变患者的血清超敏C-反应蛋白、胱抑素C和半胱氨酸对比有显著性差异,多支病变组患者的血清超敏C-反应蛋白、胱抑素C和半胱氨酸水平明显高于单支病变和双支病变组(P<0.05)。不同类型冠心病患者与对照组受试者比较,总胆固醇、总三酰甘油及低密度脂蛋白胆固醇均明显高于对照组受试者,组间差异有统计学意义(P<0.05),高密度脂蛋白胆固醇明显低于对照组患者(P<0.05),而不同类型冠心病患者的血脂水平比较,则无显著性差异(P>0.05)。Pearson相关性分析显示,超敏C反应蛋白(r=0.783,P=0.0385)、胱抑素C(r=0.821,P=0.0352)和冠心病患者的病情严重程度呈正比。结论超敏C-反应蛋白、胱抑素C水平能够作为冠心病的初步诊断指标,并且血清超敏C-反应蛋白、胱抑素C和半胱氨酸的水平含量可以初步反映冠心病严重程度。更多还原

【Abstract】 Objective To observe the significance of changes of serum levels of supersensitivity C-reactive protein( CRP) and cystatin C in patients with coronary heart disease( CHD) to contribute to the diagnosis ands treatment of CHD,and to improve survival rate and life quality of patients and to enhance therapeutic effects.Methods One hundred and fifty patients who were admitted and treated in our hospital from March 2013 to March 2015 were served as CHD group,besides,the75 healthy subjects at the same period were served as control group.According to the examination results by coronary artery visualization,the patients in CHD group were redivided into single branch lesion group( n = 45),double branch lesion group( n = 50),multi branch lesion group( n = 55).The serum levels of blood lipid,supersensitivity CRP,cystatin C,homocysteine( Hcy) and free fatty acid( FFA) were detected and compared among the groups.Moreover the correlation between the expression levels of these parameters and severity of CHD was analyzed.Results Among 150 patients with CHD,there were 45 cases of single branch lesion,50 cases of double branch lesion and 55 cases of multi branch lesion.The serum levels of supersensitivity CRP and cystatin C in CHD group were significantly higher than those in control group( P < 0.05).However the serum levels of Hcy and FFA in control group were significantly lower than those in CHD group( P < 0.05).There were significant differences in the serum levels of supersensitivity CRP,cystatin C and Hcy among the patients with different kinds of CHD,which in multi branch lesion group were significantly higher than those in single branch lesion group and double branch lesion group( P < 0.05).The serum levels of total cholesterol,total triglyceride and low density lipoprotein cholesterol in patients with different kinds of CHD were significantly higher than those in control group( P <0.05),however the levels of high density lipoprotein cholesferol were significantly lower than those in control group( P <0.05).Moreover there were no significant differences in the levels of blood lipid among the patients with different kinds of CHD( P > 0.05).Pearson correlation analysis showed that supersensitivity CRP and cystatin C were positively correlated to the severity of CHD( r = 0.783,r = 0.821,respectively,P < 0.05).Conclusion The levels of supersensitivity CRP and cystatin C can be used as indexes of initial diagnosis for CHD,furthermore,the levels of supersensitivity CRP,cystatin C and cysteine can initially reflect the severity of CHD.更多还原