【摘要】 目的观察急性冠脉综合征(ACS)患者血清胱抑素C(CysC)水平变化,以探讨其与ACS的发生发展及冠脉危险严重程度的相关性。方法选取ACS患者466例,根据ACS标准分为急性非ST段抬高型ACS(NSTE-ACS)组182例和ST段抬高型ACS(STEMI)组284例;正常对照组73例。取外周静脉血,采用全自动生化分析仪检测各组患者血清CysC、血脂及血糖等生化指标,比较分析不同类型ACS患者的冠脉狭窄程度及危险程度组间血清CysC水平变化,探讨血清CysC与ACS的发生发展、冠脉严重程度和危险程度之间的关系。结果与正常对照组比较,NSTE-ACS组和STEMI组患者血清CysC水平明显升高(P <0.05)。冠脉狭窄程度越严重及Grace评分越高,血清CysC水平也随之增加(P <0.05)。Pearson相关性分析显示,血清CysC水平与Grace评分呈正相关(r=0.52,P <0.05);多因素Logistic回归分析显示,血清CysC为ACS危险严重程度的独立因素(OR=17.03,P <0.05)。血清CysC水平在ACS患者ROC曲线下面积(AUC)为0.799(P <0.05),提示血清CysC对筛查与鉴别ACS的发生发展及危险分层有重要的临床价值。结论 ACS患者血清CysC水平与冠脉狭窄及其危险严重程度呈正相关,对临床上早期筛查与鉴别诊断ACS并对其危险分层与诊治策略提供重要的临床价值。更多还原

【Abstract】 Objective To observe the changes of serum cystatin C(CysC)level in patients with acute coronary syndrome(ACS),so as to explore its relation with the occurrence and development of ACS and with the risk severity of coronary artery. Methods A total of 466 patients with ACS were selected and divided into acute non-ST-segment elevation ACS(NSTE-ACS)group(182 cases)and ST-segment elevation ACS(STEMI)group(284 cases)according to ACS criteria.There was a normal control group with 73 healthy controls.Periphereal venous blood of all groups was collected.Automatic biochemical analyzer was adopted to detect biochemical indicators such as serum CysC,blood lipid and blood glucose.We compared and analyzed the changes of serum CysC level in patients with different types of ACS in terms of the coronary stenosis degree and the risk degree.So this study investigated the relation of serum CysC with ACS occurrence and development as well as its relation with the severity and risk of coronary arteries. Results Compared with that of the normal control group,the serum CysC levels in NSTE-ACS group and STEMI group significantly increased(P <0.05).The more severe the coronary stenosis was,the higher the Grace score was,with the serum CysC level increased(P <0.05).Pearson correlation analysis showed that serum CysC level was positively correlated with Grace score(r =0.52,P <0.05).Multivariate Logistic regression analysis showed that serum CysC was an independent factor for the risk severity of ACS(OR =17.03,P <0.05).The area under ROC curve(AUC)of serum CysC level in ACS patients was 0.799(P <0.05),indicating that serum CysC had important clinical value in screening and differentiating the occurrence,development and risk stratification of ACS. Conclusion The serum CysC level of ACS patients is positively correlated with coronary stenosis and its risk severity.It provides important clinical value for early clinical screening and differential diagnosis of ACS as well as risk stratification,diagnosis and treatment strategies for ACS.更多还原