老年冠心病患者超敏C反应蛋白、D-二聚体的相关性研究

The correlation between D-dimer and high sensitivity C reactive protein for elderly patients with coronary artery disease

目的探讨老年冠心病患者超敏C反应蛋白、D-二聚体的关系。方法选取我院老年病科及内科老年冠心病患者162例,根据冠心病不同分型将患者分为稳定型心绞痛组(SAP组)、不稳定型心绞痛组(UAP组)、非ST段抬高性心肌梗死组(NSTEMI组)和ST段抬高性心肌梗死组(STEMI组),全部患者均采用免疫速率法测定血清超敏C反应蛋白水平,免疫比浊法测定D-二聚体水平,分析两者对临床心血管不良事件发生的影响及其与冠脉病变程度(Gensini积分)的关系。结果 STEMI组超敏C反应蛋白、D-二聚体水平、单项与联合检测阳性率均明显高于SAP组、UAP组和NSTEMI组,NSTEMI组上述指标均明显高于SAP组和UAP组,UAP组上述指标均明显高于SAP组,组间比较差异有统计学意义(P<0.05),其中联合检测阳性率均明显高于单项检测阳性率,差异显著(P<0.05),高C水平组患者临床心血管不良事件发生率明显高于低C水平组,高D水平组患者临床心血管不良事件发生率明显高于低D水平组,具有显著差异(P<0.05),经Pearson相关分析发现,超敏C反应蛋白与D-二聚体呈正相关(r=0.51,P=0.03),两者均与Gensini积分呈正相关(r=0.46、0.52,P=0.04、0.03)。结论超敏C反应蛋白、D-二聚体在不同老年冠心病分型中差异显著,两者均与冠脉病变程度呈正相关,且对临床心血管不良事件发生具有重要的评估作用。

Objective To investigate the correlation between D-dimer and high sensitivity C reactive protein for elderly patients with coronary artery disease. Methods A total of 162 cases of elderly patients with coronary artery disease pa-tients were selected from internal geriatric department in our hospital, according to the classification, all patients were divided into stable angina pectoris （SAP group）, coronary heart disease unstable angina pectoris （UAP group）, non ST segment elevation myocardial infarction （NSTEMI group） and ST segment elevation myocardial infarction （STEMI group）, all serum high sensitivity C reactive protein and D-dimer level were detected by immune turbidimetric method, the impact on clinical cardiovascular adverse events and the severity of coronary lesions （Gensini score） relationship were analyzed. Results High sensitive C reactive protein, D-dimer level of STEMI group single and combined detec-tion positive rate were significantly higher than SAP group, UAP group and NSTEMI group, the above indices of NSTE-MI group were significantly higher than SAP group and UAP group, the above indices of UAP group were significantly higher than SAP group with statistically significant differences between groups （P〈0.05）, the combined positive rate were significantly higher than single detection, compared with significance （P〈0.05）, clinical cardiovascular adverse events of high C levels group was significantly higher than low C group, high D group was significantly higher than low D group, compared with significant differences （P〈0.05）, the Pearson correlation analysis showed that, high sensitive C reactive protein and D-dimers were positively correlated （r=0.51, P=0.03）, both of which were related to the Gensini score was positively（r=0.46, 0.52, P=0.04, 0.03）. Conclusion High sensitivity C reactive protein, D-dimer are significant difference in different types of elderly coronary heart disease, both are positively correlated with the severity of coronary artery disease, and has an important role in the evaluation of occurrence of clinical adverse cardiovascular events.