【摘要】 目的 观察同型半胱氨酸(Hcy)、D-二聚体(D-D)及超敏C反应蛋白(hs-CRP)在急性冠脉综合征(ACS)患者外周血中的变化,探讨三者在急性冠脉综合征早期诊断及冠脉病变严重程度的临床应用价值。方法 选择198例临床确诊患者,其中急性心肌梗死(AMI)患者70例、不稳定型心绞痛(UJAP)患者98例和稳定型心绞痛(SAP)患者30例,同时选取同期30名健康体检者作为正常对照。根据冠状动脉造影结果,单支病变69例、双支病变91例、三支病变38例。均采用免疫比浊法对hs-CRP和D-D进行测定,采用循环酶法对Hcy进行测定。结果 AM/患者血浆hs-CRP、D-D及Hcy水平分别为(18.3±6.4)mg/L、(553.2±148.7)μg/L、(45.6±8.4)μmol/L;UAP患者血浆hs-CRP、D-D及Hcy水平分别为(11.3±4.8)mg/L、(491.7±136.9)μg/L、(33.6±7.2)μmol/L;SAP患者血浆hs-CRP、D~D及Hcy水平分别为(6.9±3.3)mg/L、(304.3±124.5)μg/L、(27.8±6.8)μmol/L,均显著高于健康对照组(P<0.05)。SAP、UAP、AMI组分别与健康对照组相比较、UAP、AMI组分别与SAP组相比较、AM/组与UAP组相比较差异有统计学意义(P<0.05)。三支病变患者血浆Hcy、hs-CRP和D-D水平均明显高于双支病变和单支病变患者。结论对于急性冠脉综合征患者,血清Hcy、hs-CRP和D-D水平能够较为准确地反映病情严重程度,对早期诊断、早期治疗提供依据,有助于改善患者的预后。更多还原

【Abstract】 Objective To observe the changes and clinical values of Homocysteine(Hcy),D-dimmer(DD) and hypersensitive C-reactive protein(hs-CRP) in patients with acute coronary syndrome(ACS)in peripheral blood.Methods 198 cases of clinically diagnosed patients were selected,including 70 cases of patients with acute myocardial infarction(AMI),unstable patients with angina pectoris(UAP) in 98 cases.And at the same time30 cases of healthy physical examination were selected as normal controls.The results of coronary angiography showed 69 cases with single vessel disease,91 cases with double vessel disease,38 cases with three lesions.The levels of hs-CRP and D-D were determined by immune turbidimetry,Hcy measured by circulating enzymatic determination.Resluts In AMI patients,plasma hs-CRP,D-D and Hcy levels were(18.3±6.4)mg/L,(553.2±148.7)μg/L and(45.6±8.4)μmol/L;in UAP patients,the plasma hs-CRP,D-D and Hcy levels were(11.3±4.8)mg/L,(491.7±136.9)μg/L and(33.6±7.2)μmol/L;in SAP patients,plasma hs-CRP,D-D and Hcy levels were(6.9±3.3)mg/L,(304.3±124.5)μg/L and(27.8±6.8)μmol/L.These lelels were all significantly higher than the control group(P<0.05).There were also exist significant difference when compared UAP,AMI group with SAP,and compared AMI with UAP(P<0.05).In patients with 3 vessels lesion,the levels of plasma Hcy,hsCRP and D-D levels were significantly higher than patients with double branch lesions and single lesion.Conclusion For acute coronary syndrome patients,serum Hcy,hs-CRP and D-D levels can reflect the illness severity,provide a basis for early diagnosis,early treatment,help to improve the prognosis of patients.更多还原