同型半胱氨酸和超敏C 反应蛋白与冠状动脉粥样硬化性心脏病的相关性分析

Correlations of homocysteine and hypersensitive c-reactive protein with coronary heart disease

摘要:

目的 探讨血清中同型半胱氨酸（Hcy）和超敏C 反应蛋白（hs-CRP）水平与冠状动脉粥样硬化性心脏病（冠心病）的相关性，分析其对冠心病诊断及分期的临床意义。方法 选取110 例冠心病患者作为实验组。其中，稳定型心绞痛的患者（SAP 组）35 例，不稳定型心绞痛的患者（UAP 组）32 例，急性心肌梗死的患者（AMI 组）43 例。选取30 例健康体检者作为对照组。分别采用循环酶法和乳胶比浊法测定实验组和对照组的血清Hcy 和hs-CRP 水平，并进行统计分析。结果 冠心病各亚组血清Hcy、hs-CRP 水平与对照组比较，差异均有统计学意义（P <0.05）。冠心病各亚组血清Hcy 水平比较，AMI 组>UAP 组>SAP 组，差异均具有统计学意义（P <0.05）。AMI 组的hs-CRP 水平分别与UAP 组和SAP 组比较，差异均有统计学意义（P <0.05）；UAP 组的hs-CRP 水平与SAP 组比较，差异无统计学意义（P >0.05）。SAP 组和UAP 组血清Hcy 与hs-CRP 的水平无相关性（r =0.263，P >0.05 ；r =0.311，P >0.05）。AMI 组血清Hcy 与hs-CRP 的水平呈正相关（r =0.559，P <0.05）。结论 Hcy 和hs-CRP 与冠心病的发生密切相关，血清高水平的Hcy 及hs-CRP 是反映冠状动脉病变严重程度的良好指标，对于冠心病的患病风险预测及冠心病的诊断、分期、预后评估都起着十分重要的作用。

Abstract:

Objective To investigate the correlations of serum homocysteine (Hcy) and hypersensitive C-reactive protein (hs-CRP) levels with coronary heart disease and analyze their clinical significance for diagnosis and staging of coronary heart disease. Methods Circulating enzymatic assay and latex turbidimetric method were respectively used to determine the levels of serum Hcy and hs-CRP in 110 patients with coronary heart disease.There were 35 cases in stable angina pectoris (SAP) group, 32 cases in unstable angina pectoris (UAP) group and 43 cases in acute myocardial infarction (AMI) group; meanwhile 30 healthy cases having physical examinations were taken into control group. Results The Hcy and hs-CRP levels in each subgroup of coronary heart disease were statistically different from those in the control group (P < 0.05). In comparison of the level of Hcy among various subgroups of coronary heart disease, AMI group >UAP group >SAP group, the differences were statistically significant (P < 0.05). The level of hs-CRP in the AMI group was statistically different from that in the UAP group and the SAP group (P < 0.05), while there was no statistically significant difference between the UAP group and the SAP group (P > 0.05). The level of Hcy and hs-CRP had no correlation in the SAP group and the UAP group (r = 0.263 and 0.311, P > 0.05). The level of serum Hcy and hs-CRP had positive correlation in the AMI group (r = 0.559, P < 0.05). Conclusions Hcy and hs-CRP are closely related to the occurrence of coronary heart disease. Elevated serum Hcy and hs-CRP levels are good indicators for the severity of coronary artery lesions, which play very important roles in predicting the risk, diagnosis, staging and prognosis assessment of coronary heart disease.