冠心病患者血清同型半胱氨酸、超敏C反应蛋白、脂蛋白（a）及D-二聚体联合检测的意义

Application of homocysteine, serum high sensitive C-reactive protein, lipoprotein A and D-two dimer com- bined detection in the course of coronary heart disease

目的探讨同型半胱氨酸（Hcy）、超敏C-反应蛋白（hs-CRP）、脂蛋白（a）[LP（a）]和D-二聚体（DD）联合检测在冠心病诊疗中的应用价值。方法对180例冠心病患者（冠心病组）和同期来该院体检合格的健康人200例（对照组）分别检测Hcy、hs．CRP、LP（a）和DD水平，比较两组各项检测指标的差异。结果冠心病组Hcy、hs．CRP、LP（a）和DD含量均明显高于对照组（t=13．87、10．24、9．86、18．02，均P〈0．05）。冠心病患者各组间各项指标比较：AMI组明显高于UAP组（t=15．79、9．73、11．47、17．34，均P〈0．05）、UAP组明显高于SAP组（t=16．82、8．14、10．65、18．27，均P〈0．05）、SAP组明显高于SMI组（t=14．36、10．35、9．98、16．52，均P〈0．05）。结论对冠心病患者血清Hcy、hs-CRP、LP（a）和DD联合检测有助于了解冠心病病程发展，评估冠心病风险。

Objective To study the meaning of Homocysteine, serum high sensitive C-reactive protein, lipo- protein A and D-two dimer combined detection in the course of coronary heart disease. Methods Select 180 cases suffering from different types of coronary heart disease as group of coronary heart disease,200 healthy people who were in our hospital physical examination qualified over the same period as the control group, all the cases of fasting venous blood was sampled respectively to detect the content of Hcy, hs-CRP, LP （a） and DD. Results Coronary heart dis- ease group of patients with Hcy, hs-CRP, LP（a） and DD levels were significantly higher than those of the control group of healthy persons （ t = 13.87,10.24,9.86,18.02, P 〈 0.05 ）, Comparison among different indicators of the pa- tiens with Coronary heart disease ： the group of AMI was higher than the group of UAP （ t = 15.79,9.73,11.47, 17. 34, all P 〈 0.05）, the group of UAP was higher than the group of SAP （ t = 16.82,8.14,10.65,18.27, P 〈 0.05）,the group of SAP was higher than the group of SMI（t = 14. 36, 10. 35,9. 98, 16. 52,P 〈 0. 05）. Conclusion Monitoring of Hcy, hs-CRP, LP（a） and DD for coronary heart disease, contributes to the understand of the development of the course of coronary heart disease and assess the risk of coronary heart disease.