冠心病人血清超敏C反应蛋白、尿酸和脂质水平检测的临床应用价值评估

Clinical application value evaluating of serum hs-CRP, UA and lipid level detection in patients with coronary heart disease

目的：检测初诊冠心病（CHD）病人空腹血清超敏C反应蛋白、尿酸和相关脂质水平，同时应用ROC曲线评价各指标临床应用价值。方法：随机选取2013年10至2014年6月来院就诊的80例初诊CHD患者为研究组和30例同期体检健康者为对照组，测定两组人群空腹血清超敏C反应蛋白（hsCRP）、尿酸（UA）、三酯酰甘油（TG）、总胆固醇（TC）及高密度脂蛋白胆固醇（HDL-C）含量，并应用ROC曲线进行临床应用价值评估。结果：与对照组相比，初诊冠心病组空腹血清hsCRP、UA、TG、TG/HDL-C、TC/HDL-C水平均明显升高（t=2.43～3.27，P＜0.01～0.05）；HDL-C明显降低（t=-4.6，P＜0.001）。TC无显著性差异（t=0.9，P=0.371〉0.05）。ROC曲线下面积hsCRP、TG/HDL-C、UA、TG和TC/HDL-C分别为：0.88、0.754、0.735、0.688和0.683，有统计学意义（P≤0.001～0.05）。结论：血清hsCRP、UA、TG、TG/HDL-C、TC/HDL-C增高和HDL-C的降低都是冠心病发病的危险因素，各指标对早期CHD的临床应用价值依次为hsCRP、TG/HDL-C、UA、TG、TC/HDL-C。各地区可结合实际情况在CHD的早期预防和诊治中联合检测各危险因素，寻找适合本地区的生物学指标并建立诊断切点值。

Objective：To evaluate some risk factors（hs-CRP, Uric acid, lipids etc al.）of biochemistry related to the CHD by ROC curve. Methods：Detected the concentration of hsCRP、UA、TG、TC and HDL-C in CHD group and control group by auto biochemistry analyzer.Results：The level of serum hsCRP、UA、TG、TG/HDL-C、TC/HDL-C increased and HDL-C decreased in CHD group, there has significant differences, however, TC has no significant difference between CHD group and control group. The area of ROC curve of hsCRP、TG/HDL-C、UA、TG and TC/HDL-C were 0.88、0.754、0.735、0.688 and 0.683 respectively and had statistical significant. Conclusions：①The concentration of hsCRP、UA、TG、TG/HDL-C、TC/HDL-C increase and HDL-C decrease are the risk factor for the CHD disease. the clinical value of CHD were hsCRP, TG/HDL-C , UA, TG, TC/HDL-C respectively.②The area should be combined to detect the risk factors for CHD prevention and early diagnosis, searching for the biological indicators in the region and to establish diagnostic cutoff point.