老年下肢动脉粥样硬化患者检测同型半胱氨酸、C反应蛋白及踝臂指数的临床意义

Clinical significance of detecting homocysteine,C-reactive protein and ankle brachial index in elderly patients with lower limb artherosclerosis

目的探讨老年下肢动脉粥样硬化患者检测同型半胱氨酸(Hcy)、C反应蛋白(CRP)及踝臂指数(ABI)的临床意义。方法选取2007年2月—2010年10月85例老年下肢动脉粥样硬化患者,根据超声检测的动脉内膜中层厚度(IMT)分为斑块组(37例)与非斑块组(48例),并选取同期住院的非下肢动脉粥样硬化老年患者40例设为对照组。回顾性分析3组患者的Hcy、hs-CRP及ABI特征,并观察斑块组与非斑块组的心血管事件发生率。结果 Hcy、hs-CRP表达水平在斑块组、非斑块组和对照组中呈逐步下降的趋势,组间比较有显著差异(P<0.05或P<0.01);ABI在3组中呈逐步升高的趋势,组间比较有显著差异(P<0.05或P<0.01)。斑块组与非斑块组的心血管事件的发生率分别为10.81%(4/37)、4.17%(2/48),2组无显著差异(P>0.05)。结论老年下肢动脉粥样硬化患者存在Hcy代谢异常、CRP表达水平升高及低ABI值等特征,检测这些指标可为临床诊断提供参考价值。

Objective To explore the clinical significance of detecting homocysteine（Hcy）,C-reactive protein（CRP） and ankle brachial index（ABI） in elderly patients with lower limb artherosclerosis. Methods A total of 85 elderly patients with lower limb artherosclerosis in our hospital from Feb. 2007 to Oct. 2010 were divided into plaque group（37 cases） and non-plaque group（48 cases）according to the intima-media thickness（IMT） detected with ultra-sound. And another 40 elderly patients with non-lower limb artherosclerosis served as control group. Hcy,hs-CRP and ABI characteristics were retrospectively analyzed among 3 groups and cardiovascular events were compared between plaque and non-plaque groups. Results Hcy and hs-CRP expression levels decreased gradually whereas ABI increased gradually and there were significant differences among 3 groups（P〈0. 05 or P〈0. 01）. The rates of cardiovascular events of plaque and non-plaque groups were 10. 81%（4 /37）and 4. 17%（2 /48）,respectively,but the difference was not statistically significant（P〉0. 05）.Conclusion Elderly patients with lower limb artherosclerosis have abnormal Hcy metabolism,and increased CRP expression and decreased ABI value can provide significant references for clinical diagnosis.