【摘要】 目的:探讨冠心病患者同型半胱氨酸(Hcy)、纤维蛋白原(Fg)、高敏C反应蛋白(hsCRP)、D二聚体(D-D)水平与其肠道菌群的相关性。方法:选择我院124例冠心病患者为研究对象(冠心病组),另选择47例健康体检者作为健康对照组。检测并比较两组血清Hcy、Fg、hsCRP、D-D水平及肠道菌群[乳酸杆菌(Lac)、双歧杆菌(Bif)、大肠杆菌(Eco)]水平，分析各血清指标对冠心病的诊断价值及其与肠道菌群的相关性。结果:与健康对照组比较，冠心病组血清Hcy[(15.25±5.74)μmol/L比(21.73±6.02)μmol/L]、Fg[(3.24±1.26)g/L比(4.43±1.32) g/L]、hsCRP[(5.74±2.51)mg/L比(9.19±3.67) mg/L]、D-D[(0.51±0.15)mg/L比(0.66±0.23) mg/L]水平显著升高，Lac[(31.83±0.52)CFU/g比(27.97±0.47) CFU/g]、Bif[(26.39±0.16) CFU/g比(25.51±0.23) CFU/g]、Eco[(26.14±0.49) CFU/g比(23.28±0.41) CFU/g]水平均显著降低，P均=0.001;血清Hcy诊断冠心病的价值最高，曲线下面积(AUC)为0.777,最佳截断值下诊断敏感度为81.45%,特异度为65.96%;Pearson相关分析显示Hcy、Fg、hsCRP、D-D水平分别与Lac、Bif、Eco呈显著负相关(r=-0.584～-0.408,P均=0.001)。结论:冠心病患者血清Hcy、Fg、hsCRP、D-D水平与肠道菌群水平呈显著负相关，纠正肠道菌群紊乱可作为冠心病的辅助治疗方法。更多还原

【Abstract】 Objective:To explore the correlation among serum levels of homocysteine(Hcy), fibrinogen(Fg), high sensitive C-reactive protein(hsCRP), D-dimer(D-D) and intestinal flora in patients with coronary heart disease(CHD).Methods: A total of 124 CHD patients from our hospital were enrolled as CHD group, another 47 healthy subjects were regarded as healthy control group.Serum levels of Hcy, Fg, hsCRP, D-D, and intestinal flora[Lactobacillus(Lac), Bifidobacterium(Bif), Escherichia coli(Eco)]were measured and compared between two groups, diagnostic value of above serum indexes for CHD and their correlation with intestinal flora were analyzed.Results: Compared with healthy control group, there were significant rise in serum levels of Hcy[(15.25±5.74)μmol/L vs.(21.73±6.02) μmol/L], Fg[(3.24±1.26)g/L vs.(4.43±1.32) g/L], hsCRP[(5.74±2.51)mg/L vs.(9.19±3.67) mg/L], D-D[(0.51±0.15)mg/L vs.(0.66±0.23) mg/L], and significant reductions in levels of Lac[(31.83±0.52)CFU/g vs.(27.97±0.47) CFU/g], Bif[(26.39±0.16) CFU/g vs.(25.51±0.23) CFU/g], Eco[(26.14±0.49) CFU/g vs.(23.28±0.41) CFU/g]in CHD group, P=0.001 all; serum Hcy possessed the highest diagnostic value for CHD, area under curve(AUC) was 0.777, sensitivity and specificity was 81.45%, 65.96% respectively at cutoff point; Pearson correlation analysis indicated that serum levels of Hcy, Fg, hsCRP and D-D were significant inversely correlated with levels of Lac, Bif and Eco(r=-0.584～-0.408, P=0.001 all).Conclusion: Serum levels of Hcy, Fg, hsCRP, D-D are significantly inversely correlated with intestinal flora in CHD patients.Correcting intestinal flora disorder may be used as a auxiliary therapeutic method for CHD.更多还原