血清同型半胱氨酸和高敏C反应蛋白在不稳定型心绞痛危险度分层中的作用

Effects of serum homocysteine and hypersensitive C-reactive protein on risk classification of unstable angina pectoris

目的探讨同型半胱氨酸(homocysteine,Hcy)和高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)在不稳定型心绞痛(unstable angina pectoris,UAP)危险度分层中的作用。方法(1)按照中华医学会心血管病学分会《不稳定型心绞痛和非ST段抬高心肌梗死诊断与治疗指南》中的危险性分层将102例UAP患者分为低、中、高3个危险组;(2)测定102例UAP、20例稳定型心绞痛(stable angina pectoris,SAP)及46例对照者的血清Hcy和hs-CRP的含量,分别比较其在3组中的差异。结果(1)UAP组血清Hcy[(21±9)ng/L]、[hs-CRP(12.2±7.3)mg/L]水平明显高于SAP组及对照组(P<0.05,P<0.01);(2)UAP患者低、中、高危组血清Hcy浓度分别为(17±6)ng/L、(21±8)ng/L、(25±10)ng/L,后2组与前者比较差异有统计学意义(P<0.05);(3)UAP患者低、中、高危组血清hs-CRP浓度分别为(9±5)mg/L、(12±7)mg/L、(16±8)mg/L,后2组与前者比较差异有统计学意义(P<0.05)。结论UAP患者血清Hcy、hs-CRP水平明显升高,且随危险度分层的升高而升高,可作为UAP患者危险度分层的重要指标。

Objective To observe the effect of serum homocysteine（Hcy） and hypersensitive C-reactive protein （hs-CRP） on risk classification of unstable angina pectoris（UAP）. Methods 102 patients with unstable angina pectoris were dividedinto low, moderate and high risk groups according to the clinical classification standard proposed by Cardiology Branch of Chinese Medical Association and Editorial Board of Chinese Journal of Cardiology. The serum Hcy and hs-CRP levels in 102 patients with UAP, 20 patients with stable angina pectoris（SAP） and 46 healthy subjects （control group） were detected, then the differences among them were compared. Results The serum Hcy and hs-CRP levels in patients with UAP were significantly higher than those of patients with SAP and control group（ P 〈 0.05 or 〈 0.01）. The serum Hcy levels in low,moderate and high risk groups were （ 17 ± 6）ng/L, （21 ± 8） ng/L and （25 ± 10） ng/L respectively. There were significant differences between low risk group and moderate, high risk groups（ P 〈 0.05）. The serum hs-CRP levels in low, moderate and high risk groups were （9 ±5） mg/L, （ 12 ± 7） mg/L and （ 16± 8） mg/L respectively. There were significant differences between the former group and the two latter groups （ P 〈 0.05）. Conclusion The serum Hcy and hs-CRP levels significantly increase in patients with UAP. And the levels increase with the increase of risk grade, which suggests that the serum Hcy and hs-CRP levels can be regarded as indexes for the risk classification of UAP.