【摘要】 目的 探讨血清尿酸（UA）与同型半胱氨酸（Hcy）联合超敏C-反应蛋白（hs-CRP）在冠状动脉（冠脉）粥样硬化患者中的水平变化及临床意义。方法 选择2020年1月—2022年9月平邑县人民医院收治的50例冠脉粥样硬化患者作为试验组，根据Gensini积分法将患者分为单支血管病变组（22例）、双支血管病变组（16例）、三支血管病变组（12例）；另外选择该院同期50名健康体检者作为对照组。采用尿酸酶比色法检测UA，免疫透射比浊法检测hs-CRP，酶循环法检测Hcy；采用氧化酶法检测三酰甘油（TG）、总胆固醇（TC），直接法测定低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）。比较各组患者以及不同冠脉粥样硬化严重程度患者的UA、Hcy、hs-CRP与血脂指标水平差异。结果 试验组的UA、Hcy、hs-CRP、TG、TC、LDL-C水平均明显高于对照组，HDL-C水平明显低于对照组[UA（μmol/L）:454.26±50.22比250.17±49.83,Hcy（μmol/L）:23.60±6.31比8.52±1.44,hs-CRP(mg/L):13.65±2.37比5.53±3.29,TG(mmol/L):3.02±0.75比1.44±0.63,TC(mmol/L):6.19±1.22比4.05±0.97,LDL-C(mmol/L):4.14±0.86比1.63±0.52,HDL-C(mmol/L):0.97±0.32比2.59±0.27，均P<0.05]。随着冠脉粥样硬化病情的不断加重，患者的UA、Hcy、hs-CRP、TG、TC、LDL-C水平均逐渐升高，HDL-C水平逐渐降低，比较差异均有统计学意义。结论 UA、Hcy、hs-CRP联合检测用于冠脉粥样硬化患者病情评估中能较好地检出疾病，反映病情严重程度，具有重要意义。更多还原

【Abstract】 Objective To investigate the changes and clinical significance of serum uric acid(UA and homocysteine(Hcy) combined with hypersensitive C-reactive protein(hs-CRP) in patients with coronary atherosclerosis. Methods Fifty patients with coronary atherosclerosis admitted to Pingyi County People’s Hospital from January 2020 to September 2022 were selected as the experimental group. According to Gensini integral method, the patients were divided into single vessel disease group(22 cases), double vessels disease group(16 cases)and three vessels disease group(12 cases). In addition, 50 healthy subjects were selected as control group. UA was determined by uricase colorimetry method, hs-CRP was determined by immunoprojective turbidimetric method, and Hcy was determined by cyclic enzyme method. Triacylglycerol(TG) and total cholesterol(TC) were determined by oxidase method, and low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C)were determined by direct method. The levels of UA, Hcy, hs-CRP and serum lipids indicators were compared among all groups and patients with different severities of coronary atherosclerosis. Results The levels of UA, Hcy, hsCRP, TG, TC and LDL-C in experimental group were higher than those in control group, while the level of HDL-C was lower than that in control group [UA(μmol/L): 454.26±50.22 vs. 250.17±49.83, Hcy(μmol/L): 23.60±6.31vs. 8.52±1.44, hs-CRP(mg/L): 13.65±2.37 vs. 5.53±3.29, TG(mmol/L): 3.02±0.75 vs. 1.44±0.63, TC(mmol/L):6.19±1.22 vs. 4.05±0.97, LDL-C(mmol/L): 4.14±0.86 vs. 1.63±0.52, HDL-C(mmol/L): 0.97±0.32 vs. 2.59±0.27,all P < 0.05]. With the aggravation of coronary atherosclerosis, the levels of UA, Hcy, hs-CRP, TG, TC and LDL-C increased gradually, and the level of HDL-C decreased gradually, with statistical significance. Conclusion The combined detection of UA, Hcy and hs-CRP could better detect the disease in patients with coronary atherosclerosis and reflect the specific degree of disease, which is of great significance.更多还原