hs-CRP、LP(a)、Fig、TB和UA与冠状动脉病变的相关性研究

Correlation of serum level of hs-CRP,LP(a),Fig,TB,and UA with coronary artery lesion

目的:探讨血清超敏C反应蛋白、脂蛋白(a)、纤维蛋白原、总胆红素和尿酸与冠状动脉病变的关系。方法:对418例行选择性冠脉造影患者,分别测定hs-CRP、LP(a)、Fig、TB和UA水平。根据冠状动脉狭窄情况分为冠状动脉正常组(冠状动脉无狭窄,85例),冠状动脉粥样硬化组(冠状动脉狭窄<50%,93例),冠状动脉单支病变组(仅有一支冠状动脉分支狭窄≥50%,155例)和冠状动脉多支病变组(有一支以上冠状动脉分支狭窄≥50%,85例),同时对其一般临床资料,包括血糖,血脂,血压,吸烟史等情况进行总结分析。结果:冠心病组中有吸烟史,且合并高血压、糖尿病、高脂血症的患者人数要明显高于非冠心病组,二者差别均具有统计学意义,P<0.05。多支病变组和单支病变组的TB水平低于正常组,而其余四项指标均高于正常组,差别均具有统计学意义(P<0.05)。Logistic回归分析表明,除UA外,其他四项均为影响冠状动脉病变的因素,其中hs-CRP的意义最大,OR为1.122。结论:高血糖,高血脂,高血压及吸烟史是冠心病的高危因素。随着冠状动脉病变程度加重,除TB显著降低外,hs-CRP、LP(a)和Fig水平均显著增高。除UA外,其他指标均可作为冠心病的评估预测指标,其中hs-CRP对冠心病的预测价值最高。

Objective：To investigate the changes of serum level of high-sensitivity C-reactive protein,lipoprotein（a）,fibrinogen,total bilirubin,and uric acid in patients with coronary artery lesion.Methods： The levels of serum hs-CRP,LP（a）,Fig,TB,and UA 418 were analyzed in patients undergoing selective coronary angiography,which were divided into normal group（n=85）,coronary artery atherosclerosis group（n=93 cases）,coronary artery single-vessel disease group（n=155 cases） and coronary artery multi-vessel disease group（n=85 cases） according to the level of coronary artery stenosis.And the general clinical data,including blood glucose,blood lipids,blood pressure,smoking history and so on were analyzed.Results： Most patients in CHD group had smoking habit and hypertension,diabetes,hyperlipidemia.Compared with patients in non-CHD group,the differences had statistically significant,P0.05.The TB level of patients in CHD group was lower than the normal group,while the remaining four indicators were higher than the normal group,the differences were statistically significant（P0.05）.Logistic regression analysis showed that,in addition to UA,the other four are the factors that influence coronary artery disease,in which the hs-CRP has the greatest significance,OR is 1.122.Conclusion： High blood sugar,high blood lipids,hypertension,and smoking history are risk factors for coronary heart disease.With the increasing degree of coronary artery lesion,in addition to significant reduction of TB level,hs-CRP,LP（a） and Fig were significantly increased.In addition to UA,the other indicators can be assessed as a predictor of coronary heart disease,and the hs-CRP has the highest predictive value for coronary heart disease.