3项指标联合检测在心脑血管疾病患者中的意义

Clinical significance of serum homocysteine,lipoprotein(a)and high sensitivity C-reaction in cardio-cerebr ovasculai disease

目的探讨血清同型半胱氨酸(Hcy)、脂蛋白(a)[Lp(a)]和超敏C反应蛋白(hs-CRP)在心脑血管疾病患者中的临床意义。方法选择2011年9月至2012年3月第四军医大学第二附属医院唐都医院90例心脑血管疾病患者为研究对象。其中50例冠心病患者为冠心病组;20例心肌梗死患者为心肌梗死组;20例脑梗死患者为脑梗死组。另选择2012年2月至2012年4月45例健康体检者为健康对照组。测定4组血清Hcy,Lp(a)和hsCRP的水平,并比较各组间的阳性率。结果冠心病组、心肌梗死组和脑梗死组血清Hcy水平均高于健康对照组,差异有统计学意义(P<0.05);冠心病组和心肌梗死组血清Lp(a)和hs-CRP水平均高于健康对照组,差异有统计学意义(P<0.05);心肌梗死组血清Hcy、Lp(a)和hs-CRP水平高于冠心病组和脑梗死组,差异有统计学意义(P<0.05)。单独检测时,心肌梗死组血清Hcy、Lp(a)和hs-CRP阳性率高于脑梗死组和冠心病组,差异有统计学意义(P<0.05)。联合检测时,Hcy与Lp(a)、Hcy与hs-CRP、Lp(a)与hs-CRP的阳性率在冠心病组、心肌梗死组和脑梗死组之间比较,差异均有统计学意义(P<0.05)。结论联合检测血清Hcy、Lp(a)和hs-CRP可预测心脑血管疾病的发生,临床上可联合检测此3项指标作为筛查心血管疾病的有效手段之一。

Objective To explore the clinical significance of homocysteine ,lipoprotein（a）and high sensitivity C-reaction protein levels in patients with cardio -cerebrovasculai disease .Methods A total of 90 patients with cardio-cerebrovasculai disease including 50 patients with coronary heart disease ,20 patients with myocardial infarction and 20 patients with cerebral infarction ,other 45 healthy individuals as healthy controls .Serum homocysteine ,lipoprotein （a）and high sensitivity C-reaction protein levels were determined .All the data were conducted by the SPSS 13 .0 .Re-sults Levels of Hcy in cardio-cerebrovasculai disease groups were significant higher than that of healthy controls （P〈 0 .05） ,level of Hcy in myocardial infarction group was significant higher than that of cerebral infarction group and coronary heart disease groups .Levels of Lp（a）and hs-CRP in coronary heart disease group and myocardial infarction group were significant higher than those of controls （P〈 0 .05） ,levels of Lp（a）and hs-CRP in myocardial infarction group were significant higher than those of coronary heart disease group and cerebral infraction group （P 〈 0 .05） . Conclusion The combined detection of serum Hcy ,Lp（a）and hs-CRP could predicte cardio-cerebrovasculai disease .