摘要
目的:分析同型半胱氨酸(Hcy)、C反应蛋白(CRP)、胱抑素C(Cys C)等生化指标用于冠心病诊断的价值。方法:采用前瞻性研究方法,选择2019年1月—2022年8月昭通市第一人民医院收治的313例冠心病患者,根据冠脉病变评分(Gensini评分)分级,从中抽取出轻微、一般、明显、严重程度狭窄患者各20例,分别纳入A组、B组、C组、D组,另依据1∶1的纳入原则随机抽样,选取同期医院20例健康体检者为对照组。比较各组生化指标水平,分析生化指标水平与冠心病患者病情程度指标相关性。比较不同预后结局患者生化指标水平,评估与CHD存在关联性的指标对冠心病预后不良的预测效能。结果:A组、B组、C组、D组的总胆固醇(TC)、肌酐(Cr)、Cys C、Hcy、纤维蛋白原(FIB)、CRP与对照组比较,差异有统计学意义(P<0.05);A组、B组、C组、D组的TC、Cr、FIB比较,差异无统计学意义(P>0.05),A组、B组、C组、D组的Cys C、CRP、Hcy均依次升高,差异有统计学意义(P<0.05)。Hcy、Cys C、CRP与Gensini评分、造影显示血流受限程度均呈正相关(r>0,P<0.05)。预后较好组和预后不良组TC、Cr、FIB比较,差异无统计学意义(P>0.05),预后不良组Cys C、CRP、Hcy水平高于预后良好组,差异有统计学意义(P<0.05)。绘制ROC曲线,Hcy、Cys C、CRP预测冠心病预后不良风险的AUC均>0.900。结论:冠心病患者Cys C、CRP、Hcy与健康人存在差异,而且三者水平在一定程度上显示了患者冠脉狭窄及心肌缺血程度。
Objective:To analyze the clinical value of biochemical indexes such as homocysteine(Hcy),C-reactive protein(CRP),cystatin C(Cys C)in patients with coronary heart disease diagnosis.Method:In this prospective study,313 patients with coronary heart disease admitted to Zhaotong First People's Hospital from January 2019 to August 2022 were selected,according to the Gensini score,there were 20 patients of mild,general,obvious and severe stenosis were selected respectively,and they were included in group A,group B,group C and group D.In addition,according to the 1 to 1 principle of random sampling,20 healthy patients in the same period were selected as the control group.The levels of biochemical indexes in each group were compared,and the correlation between the levels of biochemical indexes and the disease severity indexes of patients with coronary heart disease was analyzed.The biochemical indexes of patients with different prognostic outcomes were compared to evaluate the predictive efficacy of the indexes associated with CHD for poor prognosis of coronary heart disease.Result:The total cholesterol(TC),creatinine(Cr),Cys C,Hcy,fibrinogen(FIB)and CRP in groups A,B,C and D were significantly different from those in the control group(P<0.05).There were no significant differences in TC,Cr and FIB in group A,group B,group C and group D(P>0.05),while Cys C,CRP and Hcy in group A,group B,group C and group D were increased successively,the differences were statistically significant(P<0.05).Hcy,Cys C and CRP were positively correlated with Gensini score and the degree of blood flow limitation shown by angiography(r>0,P<0.05).There were no statistically significant differences in TC,Cr and FIB between the good prognosis group and the poor prognosis group(P>0.05),while the levels of Cys C,CRP and Hcy in the poor prognosis group were higher than those in the good prognosis group,the differences were statistically significant(P<0.05).ROC curve was drawn,and the AUC of Hcy,Cys C and CRP in predicting the risk of poor prognosis of coronary heart disease were all>0.900.Conclusion:There are differences in Cys C,CRP and Hcy between patients with coronary heart disease and healthy people,and the levels of these three factors indicate the degree of coronary artery stenosis and myocardial ischemia in patients to a certain extent.
作者
张国坤
母海华
ZHANG Guokun;MU Haihua(Zhaotong First People's Hospital,Zhaotong 657000,China;不详)
出处
《中外医学研究》
2023年第16期82-86,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
冠心病
同型半胱氨酸
C反应蛋白
胱抑素
预后预测
病情评估
Coronary heart disease
Homocysteine
C-reactive protein
Cystatin Prognosis prediction
Disease assessment
