【作者】 张春芳；

【导师】 傅国胜；

【作者基本信息】 浙江大学 ， 内科学（心血管病）， 2018， 硕士

【摘要】 目的:研究分析急性冠脉综合征(ACS)患者血清胆碱酯酶(CHE)水平与ACS的相关性,探讨CHE在ACS中的作用与意义。方法:以2014年10月至2016年10月就诊于浙江大学医学院附属邵逸夫医院心内科,诊断为ACS的患者264例为研究对象,将其分为非ST段抬高性急性冠脉综合征(NSTE-ACS)组(n=89)和急性ST段抬高性心肌梗死(STEMI)组(n=175),回顾性分析2组患者的一般人群资料(年龄、性别、吸烟史、有无合并糖尿病及高血压病),将2组患者的各项指标,包括血清胆碱酯酶(CHE)、白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、血糖(Glu)、糖化血红蛋白(HbAlc)、尿素(Ure)、肌酐(Cr)、支架置入数、支架置入位置(左前降支(LAD)、左主干(LM)、右冠状动脉(RCA)、左回旋支(LCX))及EuroscoreⅡ评分对比分析,并对CHE与ACS患者各项指标进行相关性分析。结果:STEMI 组 CHE、吸烟史、EuroscoreⅡ评分、WBC、Glu、LDL-C、TC 水平高于NSTE-ACS组,差异有统计学意义(P<0.05);相关性分析结果表明,CHE与ACS 患者吸烟史、TG、TC、LDL-C、Glu、HbAlc 呈正相关(r吸烟史=0.19、rTG=0.27、rTC=0.29、rLDL-C=0.18、rGlu=0.15、rHbA1c=0.19,P<0.05),与年龄、hs-CRP、Ure、Cr 呈负相关(r年龄=-0.39、rhs-CRP=-0.17、rUre=-0.27、rCr=-0.26,P<0.05)。结论:血清CHE水平在STEMI患者较NSTE-ACS患者升高,其水平在一定程度上可反映ACS的严重程度。更多还原

【Abstract】 Objective:To investigate the correlation between serum cholinesterase(CHE)level and acute coronary syndrome(ACS),and to explore the role and significance of CHE on the patients with acute coronary syndrome.Methods:A retrospective analysis on 264 ACS cases in the Department of Cardiology,Sir Run Run Shaw Hospital affiliated to Zhejiang University school of Medicine from October 2014 to October 2016 was conducted.The patients were divided into Non-ST-segment elevation acute coronary syndrome(NSTE-ACS)group(n=89)and acute ST-segment elevation myocardial infarction(STEMI)group(n=175).The basic clinical data of the 2 groups were observed(such as age,gender smoking history,and combination of diabetes and hypertension).The serum cholinesterase(CHE),white blood cell count(WBC),high sensitive C reactive protein(hs-CRP),total cholesterol(TC),three glycerol(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),blood glucose(Glu),glycosylated hemoglobin(HbAlc),urea(Ure),creatinine(Cr),the number and position(LAD,LM,RCA,LCX)of stent implantation,Euroscore II score of patients in 2 groups were compared.The correlation analysis between the clinical parameters and CHE in ACS patients was conducted.Results:The levels of CHE,smoking history,Euroscore Ⅱ score,WBC,Glu,LDL-C and TC of the patients in STEMI group were higher than NSTE-ACS group.The difference between 2 groups was statistically significant(P<0.05).The result of correlation analysis showed that CHE was positively correlated with smoking history,TQ TC,LDL-C,Glu,HbAlc(rsmokin hisory=0.19,rTG=0.27,rTC0.29,rLDL-C=0.18,rGlu=0.15,rHbAlc=0.19,P<0.05),and negative correlated with age,hs-CRP,Ure,Cr(rage=-0.39,rhs-cRP=-0.17,rUre=-0.27,rCr=-0.26,P<0.05).Conclusion:The level of serum CHE in STEMI patients is higher than that of NSTE-ACS patients,and the level of serum CHE can reflect the severity of ACS to a certain extent.更多还原