血清可溶性CD14和肌酐在冠心病评估中的价值

Value of serum soluble CD14 and creatinine in evaluating coronary heart disease

目的探讨外周血清可溶性CD14(sCD14)和肌酐(Cr)在冠心病(CHD)患者病情评估中的价值。方法 CHD患者154例分为急性心肌梗死(A组,54例)、不稳定型心绞痛(B组,60例)和稳定型心绞痛(C组,40例)三组;冠状动脉造影术正常的50例患者作为对照(D组)。根据首次血清Cr浓度分为E组(106μmol/L≤Cr≤194μmol/L,82例)和F组(Cr<106μmol/L,72例)。乳胶比浊法、酶联免疫吸附法、氧化酶法分别测定并比较各组血清C反应蛋白(CRP)、sCD14和Cr水平。结果 A、B组血清CRP、sCD14和Cr浓度均高于C、D组,A组亦高于B组(P<0.05);C组Cr浓度高于D组(P<0.05)。E组血清CRP和sCD14浓度均高于F组(P<0.05)。血清sCD14、Cr与CRP呈正相关(r=0.717、0.623,P<0.01);血清sCD14与Cr呈正相关(r=0.568,P<0.01)。结论血清sCD14和Cr水平均能够反映CHD的严重程度,且与CHD,尤其是急性冠脉综合征可能存在密切联系的炎性机制。

Objective To explore the value of serum soluble CD14（sCD14） and creatinine（Cr） in evaluating coronary heart disease（CHD）. Methods A total of 154 patients with CHD was divided into three groups of A（acute myocardial infarction, 54 cases）, B（unstable angina pectoris, 60 cases） and C（stable angina pectoris, 40 cases）. Fifty patients with normal coronary angiography served as normal controls（group D）. According to the first serum Cr concentration, 154 patients with CHD were divided into group E（106μmol/L≤Cr≤194μmol/L,82cases） and group F（Cr〈106μmol/L,72 cases）. Serum C reactive protein（CRP）, sCD14 and Cr levels were measured by latex turbidimetry method, ELISA and oxidation enzyme method, respectively. Results Serum CRP, sCD14 and Cr levels in groups of A and B were higher than those in groups of C and D,which were higher in group A than those in group B（P〈0. 05）. Serum Cr level was higher in group C than that in group D（P〈0. 05）. Serum CRP and sCD14 levels were higher in group E than those in group F（P〈0. 05）. Serum sCD14 and Cr levels were positively correlated with CRP（r=0. 717,0. 623, P（0. 01）. Serum sCD14 was positively correlated with Cr（r=0. 568,P〈0. 01）. Conclusion Serum sCD14 and Cr levels can reflect the severity of CHD, which are closely related to the inflammatory mechanism of CHD, especially in the patients with acute coronary syndrome.